The Fight To Save State’s Immigrant Health Care Program: ‘We Are Not A Burden. We Contribute’

CHICAGO — Immigrant advocates and medical experts are calling on local officials to preserve a state program slated to end this summer that provides health care to more than 33,000 immigrants.

“I’m really concerned about not having health insurance. Without it, I’m going to stop getting [many] treatments,” said Gabriela Piceno, a Southwest Side neighbor and recipient of the Health Benefits for Immigrant Adults program.

The program provides health care for low-income adults ages 42-64 who are not eligible for Medicaid due to their immigration status. Amid a projected state budget deficit and previously underestimated program costs, state officials announced it won’t be renewed next year. A similar program for people older than 65 will continue, state officials said.

When Piceno loses coverage June 30, she will face difficult choices as she might have to delay dental treatments she was about to start, skip doctor visits and stop counseling sessions, she said.

Before enrolling in the program, Piceno rarely visited the doctor due to the cost of visits and treatment. Since receiving these health benefits, she has been able to regularly visit a clinic near her house, while also seeing a gynecologist, a primary care doctor, a dentist and a counselor. She said she has an appointment in the next month with an eye doctor to get diagnosed for vision issues.

“I don’t know what I’m going to do. I will have to interrupt my care or pick what is less expensive,” said Piceno, who was recently diagnosed with pre-diabetes.

Thousands of people could see interruptions to their treatment for chronic diseases like diabetes and hypertension, miss preventive care screenings for cancer, skip vaccines or stop getting medical care altogether, medical providers told Block Club.

“The biggest challenge is going to be getting them medications,” said Miranda Hart, an internal medicine doctor at Erie Family Health Center, 2750 W. North Ave.

The federally qualified health center offers affordable medical, dental and behavioral health services. Insured and uninsured patients get care, treatment and medicine with costs varying based on a sliding scale. Between 60-70 percent of patients have Medicaid, and about 2,800 patients are insured under the state program, Hart said.

“They could be facing $150 or more every time they go to the pharmacy. For people who are struggling to put food on the table despite working full time, paying their rent and necessities, that cost at the pharmacy is often prohibitive,” Hart said.

As patients skip treatment for chronic diseases, these conditions could worsen, leading to complications that require urgent medical care or hospital visits.

“All Illinoisans will bear the cost for these health care cuts,” said Enddy Almonord, director of the Healthy Illinois Campaign, which leads a coalition of organizations advocating for affordable health care regardless of immigration status.

The program’s end could burden the entire healthcare system as local hospitals and clinics could be treating more uninsured patients who may not be able to cover the costs of care, medical providers and advocates said.

After the health care programs for immigrant seniors launched, hospital bad debt declined by an average of 15% statewide, or an average of $1.5 billion per hospital each year, according to a preliminary research report by the University of Chicago. Bad debt refers to outstanding balances on hospital bills that the institution is unlikely to recover.

While negotiations on the 2026 state budget continue, immigrants like Piceno said state officials need to consider their contributions to the local economy and workforce. She has lived in the state for 29 years, is a mother of four and formerly worked as a house cleaner and nanny. She and her husband have always paid taxes, she said.

“We are not a burden. We contribute,” Piceno said.

In 2024, the state’s program for adults ages 42-64 cost $487 million, according to state data. In 2021, immigrant-led households in Illinois paid $8.6 billion in state and local taxes and $13.1 billion in federal taxes, according to data by the Great Cities Institute at the University of Illinois Chicago.

Cuts to the program could further strain community clinics like Erie Family Health Center, which would continue to provide services for uninsured patients at a fraction of the cost without the means to get reimbursed for the rest of the bill, Hart said.

“That then impacts our financial solvency as an organization as well,” she said. “And it can limit what types of additional wraparound services we’re able to provide for patients.”

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