The Benefits of Health Coverage for Immigrants in Illinois
Executive Summary
The April 2024 research brief, The Benefits of Health Coverage for Immigrants in Illinois, examines the economic, social, and public health impacts of Illinois’ Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors (HBIS) programs. These initiatives provide Medicaid-like coverage to low-income immigrants who are otherwise ineligible due to their immigration status. Illinois was the first state to expand such coverage to undocumented seniors in 2020 and later extended eligibility to adults ages 42–64, positioning itself as an early leader in immigrant-inclusive healthcare policy.
In fiscal year 2023, HBIA and HBIS together accounted for approximately $621 million in spending—about 1.8% of the state’s Medical Assistance expenditures and just 0.6% of the total state budget. The brief argues that this relatively modest investment generates significant returns. Immigrants in Illinois have high employment rates, with noncitizens slightly exceeding citizens in workforce participation. Immigrant-led households contribute billions of dollars annually in state, local, and federal taxes. Expanding access to healthcare supports this workforce by reducing untreated health conditions, absenteeism, and barriers to employment.
The report also highlights financial benefits. Expanded coverage reduces medical debt, delayed care, and cost-related barriers to prescriptions and treatment. Adult coverage produces spillover benefits for children, increasing children’s insurance enrollment and improving developmental and educational outcomes. Many children in Illinois live in households with uninsured noncitizen adults, making parental coverage especially consequential.
High uninsured rates among undocumented immigrants are associated with delayed care and greater reliance on emergency rooms. Expanding insurance access increases preventive care use, including routine checkups, dental visits, mammograms, and breast exams. Overall, the brief concludes that HBIA and HBIS strengthen economic stability, reduce uncompensated hospital care, improve health outcomes, and represent a sound long-term investment in Illinois’ future.