Editorial: Illinois and immigrants without permanent legal status are a health care conundrum

Should immigrants without permanent legal status who arrive in Chicago in large numbers receive free state-paid health care?

It makes sense to provide at least basic medical services to refugees and others in need. Immigrants without permanent legal status are often refugees with children who have faced strenuous journeys and have few resources. Paying attention to preventative care in the present often prevents costly emergency room visits and other costly surgeries down the road. And refugees deserve a humane welcome in the state.

No one in an advanced society wants to deny medicine to a sick child. Nor should they ever.

But US health care relies primarily on a private insurance system, something immigrants without permanent legal status typically do not have. And healthcare in this nation is extremely expensive. That explains why Gov. JB Pritzker announced some limitations on what had been closest to a carte blanche on Friday. .

The Illinois Department of Health and Family Services announced Friday that it was, essentially, in danger of over-budgeting its programs for immigrants without permanent legal status, which were spiraling out of control.

In February, Pritzker had set the cost of the program, popular with open-border progressives, at $220 million, but it proved to be unrealistic to say the least. Three months later, estimates of health care costs for immigrants without permanent legal status had soared to a staggering $1.1 billion, threatening other parts of the budget, especially the amounts earmarked for early childhood education. . This came, of course, alongside the end of federal COVID bailouts and other revenue reductions.

In 2020, ruling Democrats in the states said immigrants over the age of 65 who lacked permanent legal status would now get Medicaid-style coverage, even if they didn’t qualify for the federally funded program. That program has been expanded twice (first since the age of 55) and currently covers people aged 42 and over, although many on the left of the party want it to be extended to everyone, whatever their age and whatever the cost to taxpayers. If that were to happen, $1.1 billion wouldn’t even be close enough.

But in the Springfield budget deal announced last month, state health care spending for immigrants without permanent legal status was cut to $550 million, not the potential $1.1 billion that had been discussed. Both figures represent a huge amount of taxpayers’ money; most of the $550 million saved went towards education spending.

Friday’s news was, in essence, a roadmap for how the state plans to get to that low figure. It’s one thing to declare an intention to spend less money. Another is to reveal where the pain points will be.

The state now says it will roll back its expansionist ideas and close new enrollments in the Illinois Healthcare Benefits for Immigrant Adults program for those under 65, effective July 1, unless program enrollments exceed more than 16,500 by then. in which case it will close earlier. This will leave only the Healthcare Benefits for Immigrant Seniors program up and running.

In addition, there will now be reimbursement caps and new fees for emergency room visits and shelter services for those immigrants without permanent legal status for whom the federal government does not pay the bills.

Pritzker, generally a favorite of progressives, took it on the chin. The actions were variously described as immoral and inhumane, and the Latino Caucus City Council said it was outraged by the decision.

That rhetoric was absurd. Insurance quotas are a given for citizens, even those on low incomes, and it makes no sense to privilege immigrants without permanent legal status over those on low incomes who have complied with the rules.

Of course, the state’s financial anguish over these programs plays into the hands of Republican governors who sent migrants to Chicago and argued that the city’s welcome with open arms was only possible because it didn’t see the number of migrants seen in border states. . It’s one thing to offer the full benefits of health care to immigrants without permanent legal status, they said, but quite another when any such pledge could potentially bankrupt the state. Clearly, they are right.

We do not approve of immoral bus rides and chartered planes that use migrants seeking a better life as political pawns. It is a poor substitute for a coherent national immigration policy. And we also think that someone arriving in Illinois in bad shape should always get medical attention, regardless of their age or financial situation. (The federal government partially covers health care costs for formal asylum seekers).

Tribune voices

How it happens

Sign up to receive Chicago Tribune opinion columns and guest comments by email as soon as they are posted.

But that doesn’t mean it’s fair to pretend that the United States has a single government-run health system, similar to the British National Health Service, which offers free care to all. This is not the system that our democratically elected government has put in place, and states cannot fully take its place.

Here is the absurdity of our intractable immigration crisis: a federal government and a state government operating at poles apart, one welcoming and motivating immigrants without permanent legal status with free healthcare and the other officially discouraging and therefore deems them ineligible for benefits. To say this sends mixed signals to potential migrants abroad is an understatement. It can’t continue.

Pritzker probably erred in some of his sermons about immigrants without permanent legal status and their right to free health care, statements made when he thought the bill to the state would be less.

However, he was right to put some controls in place when the fiscal situation left him no choice: the state cannot finance free healthcare to huge numbers of immigrants without permanent legal status, especially when it does not make a comparable offer to poor citizens. Charitable and mission-based organizations, with the help and cooperation of the state, must be part of this effort to meet the urgent needs of migrants.

The state can’t just write huge checks to doctors’ offices, for-profit hospitals, and Big Pharma. There are other needs.

Join the discussion on Twitter @chitribopinions and go Facebook.

Send a letter, no more than 400 words, to the editor Here or email [email protected].