ILLINOIS — Governor J.B. Pritzker’s newly signed $55.2 billion state budget will end Medicaid-style health coverage for certain non-citizens in Illinois, reversing a previous expansion that had drawn both praise and scrutiny.
Starting July 1, the state will eliminate provisions that funded health care for low-income non-citizen adults without federal support — a benefit first expanded under Pritzker’s administration.
“It was a program that had been growing significantly in cost,” said Pritzker, noting that although he believes in universal health care, fiscal responsibility must take precedence. “We’ve got to rein it in and make sure we’re actually balancing the budget.”
Medicaid Cuts Amid Soaring Budget Growth
The fiscal year 2026 budget is the largest in Illinois history, coming in $15 billion higher than when Pritzker took office in 2019. Despite that growth, the governor emphasized the need for cost control, which led to pulling back taxpayer-funded coverage for some undocumented residents.
The budget eliminates subsidies under the Health Benefits for Immigrant Adults (HBIA) program — which cost taxpayers $330 million in 2024. However, coverage for immigrant seniors 65+ will remain intact under the Health Benefits for Immigrant Seniors (HBIS) program, with a budget of $140 million for 2026.
Republican Lawmakers Warn of Broader Fiscal Risk
Illinois Republicans have long opposed both HBIA and HBIS. Rep. Bill Hauter (R-Morton) called the rollback a long-overdue acknowledgment of their concerns.
“This budget is acknowledgment that we were right about HBIA and we will be about HBIS,” Hauter said during floor debate.
A report by the Illinois Auditor General found the two programs have cost over $1.6 billion in three years, and flagged serious internal reporting errors within the system.
Hauter also warned the state could jeopardize federal health care funding under the Affordable Care Act if it continues offering state-funded care to those deemed ineligible under federal rules.
“The people of Illinois deserve to hear if we are willing to risk the entire ACA expansion program in defense of the HBIS program,” Hauter said.
Federal Cuts to Non-Citizen Medicaid Loom
In Washington, a proposal advancing through Congress could reduce Medicaid reimbursements to states that provide health coverage to non-citizens.
According to estimates from the Kaiser Family Foundation, if passed, such a policy could cost Illinois an additional $10 billion over the next nine years in lost federal support — a figure that adds weight to Illinois lawmakers’ budget-cutting moves this year.
These updates were first reported by Advantage News, which highlighted the scope of financial and political pressures shaping the new fiscal policy.
While federal policy changes may not take effect until after the upcoming fiscal year, Illinois officials are moving proactively to reduce potential financial fallout.
Are you concerned about how these Medicaid changes could affect health care in your community? Let us know your thoughts at ChicagoSuburbanFamily.com.
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