Illinois lawmakers underestimated the cost and demand for the two healthcare programs that provide Medicaid-like coverage for certain undocumented adults, according to a report released Wednesday by Auditor General Frank Mautino. [Health News Illinois]
The programs have cost the state $1.6 billion since the one for those 65 and older launched in December 2020. The second program, which covers adults between 42 and 64, launched in 2022.
The report said that while the initial estimated number of enrollees for the senior program was 6,700, that number grew to 15,831. Estimates for the other program were 26,800 enrollees, but the actual number was 53,936.
The actual cost of the senior program between fiscal years 2021 and 2023 was $412.3 million, a figure the audit said was 84 percent higher than anticipated.
The other program's cost during those three years was $485.3 million, a nearly 284 percent increase over the expected cost.
An analysis of enrollees found more than 6,000 individuals in the programs who were listed as “undocumented” despite having a Social Security number, and more than 400 enrollees lived in the U.S. long enough to qualify for the Medicaid program.
The audit also found nearly 700 enrolled in the senior program were younger than 65.
The Department of Healthcare and Family Services, which oversees the programs, told the Auditor General that, as of this January, it had removed 21,362 enrollees through its redetermination process.
There were 19,872 enrollees removed for eligibility or procedural reasons, and another 1,490 were removed and enrolled in another healthcare program.
The report recommends that HFS and the Department of Human Services collaborate to remove unnecessary duplicate enrollees and develop controls over eligibility determinations.
The audit comes a week after Gov. JB Pritzker announced a spending plan that removes funding for the program that serves those under 65. His proposal allocates $132 million for the senior program, though new enrollment will remain paused.
He told reporters at an unrelated press conference Wednesday that the report does not reflect the challenge of people’s immigration status changing during a year, nor the redetermination effort to clean up enrollment.
“Some of those people become ineligible mid-year, and you’re still paying for them because we don’t know and maybe they don’t know that they’re no longer eligible for that program,” Pritzker said.
Republicans said the report shows the need to create more transparency around how the Pritzker administration spends on agency initiatives, specifically those related to undocumented individuals.
“What this (audit) truly does show is, while this was a good press pop for a governor trying to get more recognition on the national stage, he was unable to be trusted by the taxpayers of Illinois to actually manage and run this program properly and within cost estimated and associated to the program,” said Senate Minority Leader John Curran, R-Downers Grove.
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