U.S. Congresswoman Delia Ramirez wants to restore and expand healthcare for migrants in her home state of Illinois where they were the first to provide Medicaid-style health care benefits to undocumented immigrants in 2020. 

It was an abrupt decision by the state legislature last month to close enrollment for immigrants currently eligible for health care coverage by July 1. Gov. J.B. Pritzker’s administration announced the changes on June 16. According to a news release from the Illinois Department of Healthcare and Family Services,  it is a “temporary” enrollment pause where eligible residents ages 42 to 64 won’t be able to sign up.

The state will cap at 16,500 the number of seniors who can enroll. Everyone enrolled will have to start paying copays of $100 to $250 for hospital visits that are not eligible for matching federal reimbursement. The program also will now begin charging copays of $250 for inpatient hospitalizations and $100 for emergency room visits if the services they receive aren’t eligible for reimbursements from the federal government. Patients should also expect a 10% coinsurance charge for outpatient services at hospitals or ambulatory surgery centers.

In an interview with Al DÍA, Ramirez expressed disappointment in the decision but wants to work with the governor and the state legislature to save the program and restore benefits for thousands of migrants. 

“The solution is to step back, and create a working group that gives you an analysis of the cost of the program, the cost benefits of the program, and then a pathway to restore immediately,” Ramirez said. 

Politically, the decision pins the governor against the wall. He originally praised the program and has said he believes in health care as a human right. However, when his administration projected the cost for FY 2024 was going to cost the state well over $1 billion, the state deemed the costs too high to take on. 

“The fact that we are pausing enrollment for people that are 42 to 64 feels unacceptable to me. I think that there is something to be done and, in part, that's because I don't think that we're all clear on the real cost of the program, coupled with the real benefit, and cost savings of a program such as this,” she said. 

The program stems from the history-making provision passed by the Illinois General Assembly in June 2020 led by Ramirez, then a State Representative and Assistant Majority Leader, along with the Illinois Latino Caucus to give Medicaid access to noncitizens over 65 years old and whose income is $12,670 or less, which is at or under the federal poverty level. 

“I continue to say that one of my proudest moments in elected office was to be able to steer the state into expanding healthcare, to include non citizens,” Ramirez said. 

“During the end of May of 2020, we became the first state in the entire nation that would provide health care coverage, regardless of legal status. Since then, a couple of other states have followed.” 

The state has covered low-income undocumented children, up to age 18, under the All Kids program for years but the benefits for adults are a newer addition. 

The provision was included in the state 2021 Budget bill, which Gov. Pritzker signed into law, creating the Health Benefits for Immigrant Seniors program. In May of 2021, through the FY22 budget, the General Assembly expanded access to coverage to undocumented immigrant adults 55-64 years of age, creating the Health Benefits for Immigrant Adults program. 

In 2022, the state legislature passed an FY23 budget that expanded eligibility to the Health Benefits for Immigrant Adults program for qualifying immigrants 42 and older, no matter their immigration status. 

“We have to spend the time to get an assessment of what it costs us not to cover people. What it's costing hospitals, hospitals, communities, individuals, people that are losing jobs, because they're not in an emergency room because they got so sick with pneumonia, they now can't work for a week,” Ramirez said. 

“It's costing us far more not to cover them than to provide the care that they deserve,” she added. 

Latino lawmakers and other advocates have recently tried to expand the program, to include adults ages 19 to 41 who are currently left out (House Bill 1570 and Senate Bill 122) but now the state is tightening the reins on coverage.

The decision to pause the program has garnered criticism from several lawmakers including Chicago City Councilmembers and U.S. Rep. Jesus “Chuy” Garcia, a Chicago Democrat. 

“This is a responsibility of all of us, state legislatures, the governor's office. I don't think you can go say health care is a human right and not fight for it,” Ramirez said. 

“We have an opportunity to do this right. We can do this with fiscal responsibility and health care access,” she added. “We should all be in the place of expanding healthcare, and identifying the resources to do so. It's one of the things that we say it's a shared value.”

The governor’s administration said the program is still a success, because of the over tens of thousands of people who wouldn’t have had any health care coverage now as advocates hurried to get as many people as possible signed up before the July 1 deadline.

As of June 7, there were 63,255 people enrolled in the program, including 14,594 people 65 or older, according to Healthcare and Family Services. 

“I know that the governor's office wants to figure this out. And I know that others are anxious. The people on the ground most impacted are desperately seeking and looking for solutions. I am hopeful that we'll be able to come to some kind of negotiation in the coming weeks or restore benefits to the people that are not able to apply right now,” said the Congresswoman.