Daily Herald opinion: A gratifying display: Still, planned increases for medical-debt relief show quandary facing government budgets

State Sen. Seth Lewis was persuaded by the numbers — and some real-world experiences.

Originally an opponent of state involvement in the Medical Debt Relief Program, the Bartlett Republican became — if not a convert to, at least a friend of — the expense after a GOP colleague from downstate described how it had helped people of all parties throughout the state.

Created in 2024 in partnership with the nonprofit agency Undue Medical Debt, the program helps public bodies — like the state of Illinois or Cook County government — to purchase delinquent medical debt owed by people unable to pay and free them of the responsibility.

In a story we published Sunday, Capitol News Illinois reported that last year, the state of Illinois and Cook County paid $10 million and $7 million, respectively, to buy such debt. Their $17 million contribution lifted just under $2 billion in medical debt from the shoulders of eligible patients in need, providing an average of $1,200 in relief.

The degree of relief certainly suggests an impressive return on investment.

“Countless people across the state are living proof that this program is more than clearing numbers on a ledger. It is about giving people the freedom and the opportunity to build and live their lives,” Gov. JB Pritzker said in a press conference last week. “Lifting the burden of medical debt restores hope. It provides a sense of security.”

Pritzker wants to increase the state’s contribution to the program to $15 million next year, an understandable goal as far as it goes. But keep in mind, that’s a 50% increase. Considering the obvious impact of the program, we could be inclined to think it’s money well spent. But we have to acknowledge the spirit, if not the full degree, of reservations that Lewis also expressed in the CNI report.

“As much as we may agree that $15 million for this is a worthwhile program, the billion dollars going somewhere else that we don’t agree with will override our ability to say yes to the budget,” Lewis said.

Governments must be aware that when they assume debts like these, they have to fit them into an array of spending priorities. In the context of Illinois’ tough budget year ahead, the $15 million spent to pay some people’s health care costs may have to be balanced against $15 million that won’t be available for some other purpose.

Pritzker proposed in February a $56 billion spending plan for fiscal year 2027. Including just a modest 1.6%, increase over the current year, it is a show of some restraint. Still, that 1.6% amounts to $868 million. As lawmakers dig into the nitty-gritty of the budget they ultimately will adopt at the end of May, they must remain cognizant of the legitimate concerns that other spending goals meet the kind of responsible cost-benefit standards that can turn the heads of one-time critics.