Healthcare advocates say Illinois Medicaid expansion to undocumented immigrants makes sense

Under a new Medicaid expansion program in Illinois, qualifying undocumented immigrant adults age 42 and up can now apply for health coverage.

Luvia Quiñones, the senior director of health policy at the Illinois Coalition for Immigrant and Refugee Rights, said the Medicaid expansion program offers preventative care.

“Don’t you want your neighbor to have health coverage,” she said, “so he or she has access, and to avoid you also getting sick?

The organization is part of Healthy Illinois, a coalition advocating for healthcare coverage, regardless of immigration status. The state expanded Medicaid coverage to qualifying undocumented seniors in 2020 and lowered the age limit to 55 in April. She said an estimated 300,000 immigrants are undocumented and uninsured in Illinois. The driving belief in their work is that healthcare is a human right.

“Because we know that when a person does have health — some type of health insurance,” Quiñones said, “then it’s more likely that the person will actually go to the doctor, versus when they’re uninsured.”

Quiñones said the COVID-19 pandemic fueled the urgency to increase access to health insurance. Black and Latinos were disproportionally impacted by the pandemic.

They make up a major portion of the essential work force increasing their likelihood of getting the virus. Quiñones said that despite the risk to their lives, many folks continued to work. While COVID relief such as sick leave, unemployment benefits and COVID impact payments were available, undocumented workers were excluded.

“So, if they chose not to work for their own health, they had no means to support themselves or their family,” she said. “So, unfortunately, they were they found themselves somewhat being forced to work, because they had no other option.”

She said the new state expansion gives undocumented immigrants an avenue to obtaining health insurance that’s not available at the federal level.

“There are a significant number of uninsured that are Caucasian and African American and other nationalities, but they all have a pathway, even if it’s, [in] some cases it may not be affordable,” she said. “But when it comes to undocumented and DACA they have no pathway.”

Illinois lawmakers passed the bill as part of a larger Medicaid spending package with no support from Republicans, with several Democrats present but choosing not to vote.

In a paper published for the University of Illinois Urbana-Champaign’s Project for Middle Class Renewal, researchers recommended extending Medicaid to undocumented workers.

Researcher and economist Bobby W. Chung co-authored the paper. He said undocumented workers are taxpayers too and pay into federal and local services.

“They are also contributing to the welfare system,” he explained, “but because of the constraint[s] because of the legal status, they cannot enjoy the basic benefits.”

A report by the Institute of Taxation and Economic Policy in 2017 found that undocumented immigrants contribute over $758 million in tax revenue to Illinois alone. Researchers factor in several items including the Individual Tax Identification Numbers to calculate the amount of tax revenue, which allows folks to file without having a social security number.

While undocumented immigrants can apply for healthcare coverage, they still have to qualify.

Rocio Marungo, a certified application counselor for the DeKalb County Health Department said she often has to tell people seeking Medicaid that they make too much money to be eligible for the program. The income requirements are the same for all Medicaid applicants and are calculated using the federal poverty guidelines.

“So, if I have someone [that] called me,” Marungo said, “and it’s a couple, and they are over 42, and undocumented, they could qualify, but they have to make less than this amount.”

According to Illinois.gov, a one-person household has to make an income at or below $18,754 and a two-person household has to make an income at or below $25,268.

The coverage will include services similar to other Medicaid recipients like doctor visits, prescription drugs, and mental health care. Undocumented immigrants will still not be eligible for long-term care institutions, home and community services, and funeral expenses.

A spokesperson for the Illinois Healthcare and Family Services says as of mid-July, over 5,000 individuals in the 55 to 64 age group have signed up for the program. In the 42 to 54 age category, over 700 have enrolled.

Even with its critics, researcher Chung said the expansion doesn’t go far enough. It leaves out adults 18 to 41 years old who make up a significant part of the undocumented labor force.

“They are young and productive and hardworking workers, and they should deserve basic health care coverage,” Chung said. “So I would say, we have pointed the right direction, we’re expanding, but still, we have a lot to do in the future.”

In 2024, California is expected to become the first state to offer healthcare to all low-income undocumented immigrants, regardless of age.