Medicaid expansion to seniors who aren't U.S. citizens estimated to cost Illinois $1.8 million

Illinois could soon allow seniors who are not U.S. citizens access to Medicaid.

Tucked in a budget implementation bill that lawmakers passed last week was a provision to open up Medicaid to seniors 65 and older.

State Rep. Delia Ramirez, D-Chicago, said the benefit wasn’t debated publicly, but was put together by lawmakers in working groups. The benefit is estimated to affect fewer than 900 people with an estimated taxpayer cost of $1.8 million.

“It’s a small, small population, but investing and expanding health care coverage for them would have such an extensive return on investment for all of us,” Ramirez said.

Davesurance.com insurance broker Dave Castillo said he expects the rule change will likely mean higher Medicaid costs in Illinois down the road.

“People who have been a resident of Illinois for a while, I can see maybe they can make some provisions for that, but in its current form it’s so open I fear we could be a mecca for the over 65 who are undocumented,” Castillo said.

Castillo said Ramirez's estimate is likely to increase.

“The $2 million number seems, you know, it seems like it’s ‘oh boy, this sounds wonderful,’ I have my doubts,” Castillo said.

While there are federal provisions for Women, Infant and Children and All Kids-type of programs, Castillo said opening Medicaid to undocumented seniors isn’t allowed.

"I can see this causing fireworks at the federal level," Castillo said. "The federal government could cut out their cost-share for that."

Ramirez said the policy that passed only applies to those at the federal poverty line. She said she was not worried about conflict federal immigration laws.

“We have been in conversation with the governor while he was campaigning and just the importance of the state itself just being able to cover the access and using the resources we have at the state level just to do so,” Ramirez said.

State Rep. Chris Miller, R-Oakland, said the measure is disrespectful to citizens who’ve paid into the system all their lives. He said it was an example of reckless spending approved by Democrats. He said he was concerned the move will add to the burden of the Medicaid system.

Castillo also said the hospitals can expect to get more once the measure is implemented.

Ramirez said stats she’s been provided paint that picture.

“Hospitals will come to me and say ‘Representative, when we look at charity care, and just writing off charity care, 25 percent of what we are writing off is from undocumented communities that could have had preventive care and could have saved all of us a significant amount of money,” Ramirez said.

But whether such a move will save money, Castillo said that’s not been shown.

“It sounds all anecdotal to me,” Castillo said. “I’d like to see some numbers on that.”

The governor is expected to sign the budget implementation bill along with the state budget. If enacted, the benefit for undocumented residents over 65 would be hashed out in the administrative rule-making process.