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Seniors in one state get help affording health care, regardless of immigration status

Older folks in Illinois struggling to make ends meet will now get some help affording health care, regardless of their immigration status.

Federal law typically blocks undocumented people from accessing Medicare, non-emergency Medicaid, and the Affordable Care Act health insurance marketplace.

But in a history-making move, the Illinois legislature extended public health insurance to all low-income seniors.

The change took effect on December 1, 2020.

To be eligible, an individual must live in Illinois and:

  • Be 65 or older
  • Held a green card for less than five years or be an undocumented immigrant
  • Earned less than $12,756 in 2020 as an individual, or less than $17,240 as a couple
  • Own less than $2,000 in assets, or $3,000 for a couple (this provision is currently waived during the pandemic)

Kaiser Health News reports that the Illinois Department of Healthcare and Family Services expects to cover between 4,200 and 4,600 immigrants — most of whom will be undocumented — at an approximate cost of $46 to $50 million a year.

A Rush University Medical Center study counted approximately 3,986 undocumented seniors living in Illinois. 

Some lawmakers opposed the change. But proponents argue that since many undocumented immigrants pay taxes, they should be able to access programs like Medicare and Medicaid.

They also say the change could reduce health care costs since uninsured undocumented people may also forgo preventive care leading to higher healthcare costs in the long run.

A survey of hospitals found that Medicaid already pays about $2 billion annually for emergency services for the poor — a group that includes undocumented patients.

Advocates hope the change will spark other states to expand public health care coverage to undocumented workers of all ages. In 2019, California changed eligibility requirements for Medi-Cal coverage to allow access by undocumented adults between 19 and 25.


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