UCLA Luskin School of Public Affairs

Immigrants without legal or long-term residency are even more likely to be purposefully excluded from public healthcare or healthcare assistance. Due to the Healthy Illinois campaign and network of health equity-focused organizations, Illinois has made much progress in expanding Medicaid-like healthcare services to all low-income residents in Illinois, regardless of immigration status. Currently, Illinois has three immigrant-focused healthcare programs that are almost functionally identical to federal Medicaid: All Kids (ages 0-18), Health Benefits of Immigrant Seniors (ages 65+), and Health Care for Immigrant Adults (ages 42-64). As a result, immigrants who are federally ineligible for Medicaid between the ages of 0 to 18 and 42+ have access to state healthcare coverage. However, there is a gap in coverage for those ages 19 to 41. Using enrollment data from the Illinois Department of Health and Family Services (HFS) and analyzing interviews with HBIS/A enrollees and healthcare providers, we identified important program data such as enrollment rates, insurance claims, program costs, health conditions affecting enrollees, and gaps in program or health resources. From that analysis, a few main findings emerged. First, there are enrollees in both HBIA and HBIS throughout the state. These programs benefit not only the densely populated Cook County but the affected population that resides throughout Illinois in every community. Second, there are more 42-54-year-olds enrolled in HBIA than any other age group enrolled in HBIA or HBIS. Several factors may contribute to this enrollment rate and we encourage the program administrators to consider potential program barriers for older populations. Third, enrollees credited community-based organizations in assisting them through the application process. These organizations are a critical part of the care network.Based on data analysis informed by this research, we have provided Healthy Illinois with supporting data and recommendations for expanding Medicaid-like healthcare benefits to immigrant adults in the 19-41 age group.