Lawmakers criticize Pritzker's handling of noncitizen health care cap
Members of an oversight committee voiced concerns Tuesday that Gov. J.B. Pritzker's administration didn't sufficiently seek public input on its plan to cap enrollment in Medicaid-like health care programs for noncitizens.
The controversy centers on the Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors programs, which provide health care benefits to low-income noncitizens who would qualify for Medicaid benefits if not for their citizenship status.
During May budget negotiations, lawmakers gave the Pritzker administration authority to cap program spending through emergency rule-making, and his administration exercised that authority in late June.
Those emergency rules froze enrollment in the Health Benefits for Immigrant Adults program, which serves noncitizens aged 42 to 64, and set a cap for enrollees in the senior program. The changes also reduce reimbursement rates for two large public hospitals, institute co-payments and coinsurance for some services and transition some enrollees into the state's Medicaid managed care program in an effort to reduce costs.
According to Department of Healthcare and Family Services officials, the rules are designed to limit costs for the program, which they say would be underfunded by hundreds of millions of dollars without the changes.
"We have projected liabilities of about $1.2 billion for the program if no changes are made," agency chief of staff Ben Winick said at the rules committee's meeting in Chicago.
He noted the General Assembly allocated $550 million while giving the administration the authority to cap costs.
Pritzker's administration proposed the changes in both "emergency" and "permanent" administrative rules. While emergency rules are generally valid for 150 days, the law authorizing the administration to limit program enrollment also allows it to refile emergency rules once they expire. That means that unless the rules committee votes by a three-fifths majority to suspend them, they would remain in place as long as the department wants, at least for the next two years.
The rules committee - which consists of six Democrats and six Republicans and is responsible for overseeing policymaking within the state's executive branch - didn't take action on either the emergency or permanent rules Tuesday, although the committee can still take action at a future meeting.
Both Democratic and Republican members shared concerns that mostly focused on how the rules were developed.
Sen. Cristina Castro, an Elgin Democrat and member of the Illinois Legislative Latino Caucus, said that the agency failed to consult stakeholders in the immigrant advocacy community when developing the rules.
"You quickly filed both the emergency rule and permanent rule. There's obviously been no discussions with advocates on either, it seems," Castro told agency officials.
On the Republican side, Rep. Steven Reick of Woodstock said that the rules represented an "abdication" of the General Assembly's responsibility and that they should have been considered in legislation, not in administrative policy.
"This is another instance of a governor that thinks he can legislate on his own," Reick said. "First he did it with 47 disaster declarations and now he's doing it with emergency rule."