By: Mark Glennon*
Last week’s report from the Illinois auditor general was shocking enough, but the background makes it far worse.
The audit shows $1.6 billion spent on noncitizen healthcare, far outstripping the state’s appropriations and estimates and often including recipients not eligible for the program. What the audit doesn’t detail, however, is brazen, wanton malfeasance in how it all got started. State government knowingly printed a blank check, payable by taxpayers. Cost didn’t matter.
It began with legislation championed by Delia Ramirez (D-Chicago), then a state representative who had been appointed by local Democratic leadership after resignation of her predecessor.
In May 2020, Illinois became the first state to provide healthcare for illegal immigrants. The initial coverage that Ramirez proposed, for those 65 and older, was “tucked in near the end of the 465-page budget implementation bill that passed the Illinois General Assembly late Saturday night,” as reported by the State Journal-Register at the time.
The program would cost just $2 million per year, Ramirez, said. That estimate, apparently pulled out of thin air, became the sole cost estimate relied on. We wrote about that in 2023, as did Capital News Illinois. No further cost estimate was made. The estimate was repeated blindly by program supporters. “When progressive lawmakers first pushed for the creation [of the program,” as Capitol News Illinois correctly reiterated last week, “officials relied on advocates’ $2 million cost estimate for the program’s first year.”
Gov. JB Pritzker signed the bill without his office doing any separate cost review.
But the cost of the program blew through that estimate in just the program’s first month of operation in 2021, That’s according to a closed-door presentation by the Illinois Department of Healthcare and Family Services to lawmakers given in 2023. The cost for the initial group of senior, noncitizen coverage was $188 million between March 2022 and February 2023, per that presentation.
That’s 94 times the cost estimate from Ramirez that the state relied on.
Undeterred, Illinois gradually expanded the program to younger age groups and further cost estimates came from the Illinois Department of Healthcare and Family Services. But costs to cover new groups blew through those estimates as well, as described here in Capital News Illinois’ most recent column, Newsweek, other columns and the audit itself.
Much of bogus cost projections is due to higher enrollments than supposedly were expected. For fiscal year 2023, for example nearly 54,000 adults enrolled in the program for senior noncitizens, which is about twice the original projection of 26,800.
Keep in mind that no part of the cost of Illinois’ program is reimbursable from the federal government under Medicaid or anything else. It’s for Illinois taxpayers to cover.
Pritzker paused enrollment in the program for adults in July of 2023, and paused the program for seniors in November of that year, but that was after costs had grown to $1.1 billion.
What are Pritzker’s excuses for the wildly inaccurate cost estimates?
First, Pritzker’s office said it didn’t review the initial cost estimate because the program originated as a lawmaker-driven initiative. Many Republicans, in truth, had been screaming about cost from the start, saying the program was not thoroughly vetted in committee before being added to the budget.
In 2023, Pritzker’s office essentially said, “How dare you question a governor and Democrats who are so accomplished on budget matters.”
Specifically his office said “the only lawmakers with a proven record of balancing the budget and improving state finances are Governor Pritzker and the Democratic supermajority in the General Assembly. …. Who eliminated the bill backlog that reached $16 billion left by the Republican governor? Democrats. Whose prudent fiscal decisions led to eight credit upgrades? Democrats. Who paid additional pension payments? Democrats. Who invested hundreds of millions of dollars to rebuild our human services infrastructure after the Republican budget impasse? Democrats….”
In response to the new audit, Pritzker ducked a question last week about junk cost estimates.
Nobody has been held accountable for the phony cost numbers, and there’s no indication anybody will be. That includes Delia Ramirez, who in fact got a promotion. She was elected to the United States Congress in 2022.
Some readers here asked if those responsible could face criminal prosecution. Probably not, but the sentiment is entirely understandable.
*Mark Glennon is founder of Wirepoints.
A mess of uncertainty and litigation is sure to follow.
With $162 billion more from taxpayers, couldn’t you deliver a few bond upgrades, too
Audio and summary
By democrat standards this program was a success based on the money spent. The more a democrat spends the more successful they are. Just think of how much “grase” democrat supporters got!
Probably half the tri-county Chicago voters have a noncitizen relative or household help who benefits from this program, and figures they’d rather have state taxpayers provide Medicaid services than be responsible for those medical expenses out-of-pocket themselves.
You summed it up!
Where’s my refund
Similar to “If you like your Dr, you can keep your Dr.
LOL!!!!!!!!!!!!!
The democrats failure and follow up self aggrandizing BS is akin to an arsonist torching a building and then patting themselves on the back for calling the fire department.
For 2019, the average medical spend for a Medicare Advantage plan was $12K for medical and $4.6K for prescription drugs for a total cost per person of $16.6K. At $16.6K per person, the $2M would cover expenses for 120 people for one year. However, since Medicaid pays less than the Medicare rates (Kaiser estimates that Illinois Medicaid pays 59% of the Medicare rates), the total expected cost would drop to $9779 per person. At the lower Medicaid rates, $2M would provide for 205 people for one year. This is a reasonable estimate because the Medicare Advantage plan pays for all… Read more »
This data is readily available – You can give all that data to Delia but I can guarantee you that’s a word problem she can’t solve. Was she a CPS graduate?
As businesses & citizenry hit the exits, perhaps the frightening reality is medicaid expansion along with free medicaid on the taxpayers dime to illegal immigrants IS the biggest part of economy for an Illinois circling the drain toward bankrupt insolvency?
Besides chump Illinois taxpayer paying for free medicaid for illegal immigrants, what’s the machine going to do if DOGE/Trump starts cutting off or restricting the Medicaid $$$gravy train$$$ is a #1 worry in Springfield. Per this WSJ article, feds are providing medicaid subsidies of $1,715 per each Illinoisan for 2023. (https://www.wsj.com/opinion/medicaid-reform-republicans-democrats-entitlement-healthcare-40fc7701?st=Txe6pK&reflink=article_email_share)
I believe the vast majority of all Illinois recent job growth is in government and/ or medical services. How much of those job hirings are due to medicaid expansion w ARPA-COVID $ or free medicaid for illegal migrants on the taxpayers dime??
The pension mess shows that willful indifference to cost has been a feature of Illinois governance for decades. Also willfully pulling favorable cost and revenue estimates out of thin air. That’s how a $3.5 billion projected budget deficit just disappears.
The illegal healthcare cost debacle is just the most egregious example of how they’ve operated for a long time.
Elon Musk said the federal government treats tax dollars like confetti, hence the current $2T annual budget deficit. Well, looks like Pritzker and IL Democrats treat taxpayers money like magic beans – just poof.
Pritzker wouldn’t run his own companies this was, would he?
I don’t think he’s allowed to run any family companies.
He is ru(i)nning the state like his the family ran Superior Bank – right into the ground, while enriching themselves through other’s losses.
Just proves that very few politicians if any excelled in math. How many of our so called leaders were educated in accounting/CPA’s/finance/brokers/investments/CFO’s/money management especially in medium to large companies yet they are responsible for a $54,000,000,000 budget?
They get it. They’re dishonest.
Pritzker, whataboutism is not a valid defense. Own your mistakes.