Illinois expansion of health coverage for older adults regardless of immigration status is expected to benefit thousands of essential workers at risk

Chicago Tribune (IL)

When Maribel Cordero told her two children in 2016 that she had breast cancer but that she couldn’t afford treatment, the two grabbed empty cans the next day and set out to ask for donations at their school, the mother recalls.

“They thought that with the little money they collected, I was going to be able to pay for the surgery I needed,” said Cordero, 54, of Pilsen.

Though she was told that her stage 2 cancer needed to be treated immediately, she was denied urgent treatment because she did not have any type of health insurance. As an immigrant from Mexico living in the country without permission, she does not qualify for federal programs that offer health coverage and she can’t afford private insurance.

“There was no way to pay for the treatment so I thought: I’m going to die and who is going to care for my children?”

She managed to get treated several weeks later through charity care. Now a cancer survivor, the mother faces the long-term effects of the illness, which include copays for multiple doctor visits a month and a bill of more than $3,000 monthly for medicines.

While she said her husband and children pitch in to make sure she gets the medicine she needs, a less stressful solution is on the way.

Cordero is among 11,000 people in Illinois who would be eligible for Medicaid-like benefits under an extension to a program created last year that was the first in the nation to provide government-subsidized health benefits to seniors living in the U.S. illegally.

Under the expansion approved in the new state budget earlier this summer, adult immigrants 55 to 64 living at or below the federal poverty level would also be eligible for the program, which initially covered only seniors 65 and older, including immigrants with legal status who didn’t yet qualify for state or federal programs.

While advocates applaud the move that is expected to provide a safety net for thousands of workers in that age group who are at risk of contracting COVID-19, other leaders question the sustainability of the program.

Many immigrants in Chicago have low-paying but essential jobs, said Graciela Guzman, campaign director of the Healthy Illinois campaign, which has advocated since 2016 for a bill that would guarantee health care for all adult Illinoisans regardless of income or immigration status.

Despite being essential, she said, these workers have little access to health care because they cannot afford private insurance and are not eligible for any state or federal programs.

“COVID-19 really put a magnifying glass on a lot of the experiences that we’ve been hearing in our communities for a very long time: that people have just been systematically left out from the health care spectrum as we saw how COVID rates and COVID deaths disproportionately impacted immigrant communities,” said Guzman.

The expansion would guarantee care for thousands of immigrants and precarious workers who have been essential to keep the economy running through the pandemic, Guzman said. Many have already contracted the virus and now face the long-term effects and fear going to the doctor because they cannot afford a copay, she added.

Earlier this year, Cordero’s husband, who is 60 and is her main financial support, contracted COVID-19 and the virus quickly spread in the household. Cordero, her daughter and other family members all had the virus.

Miguel Cordero is an essential worker and couldn’t stay home even if it meant putting his wife at risk.

“Gracias a Dios,” she said, they all recovered but they were left in a deep financial crisis.

Her husband was out of work for a little more than a month and afraid to go to the doctor even though he hadn’t fully healed because he knew they couldn’t afford to pay, she said.

Both Cordero and her husband say they are thankful for the expansion that she has advocated for as a community health promoter under the Resurrection Project, a community organization that serves the immigrant community in the Chicago area.

Cordero has openly shared her experience to shine light on the realities that hundreds of families are facing — and also on the resources she has been able to find for health care despite the obstacles that she faces by living in the county illegally since she was 19.

Other states have recently followed to expand their own health care coverage for noncitizens. California approved a program to cover adults 50 and older, and Oregon’s governor signed a plan to offer health care coverage to low-income immigrants over age 19 regardless of immigration status.

“Health care should be a right, not a privilege,” said Illinois House Majority Leader Greg Harris, a Chicago Democrat, who vowed to continue supporting the movement to get health care for all adults in Illinois. The push for the bill was also championed by the Illinois Legislative Latino Caucus.

Harris said, “These folks are paying taxes, they’re shopping and working.”

“We’re taking care of them the same way we’re taking care of all of our seniors, we don’t want to exclude a group just because of one demographic characteristic,” he said.

The state allocated $36 million to the program expansion that is expected to begin in May 2022, and the estimated annual cost is $50 million, according to Jamie Munks, spokesperson for the Illinois Department of Healthcare and Family Services.

Those who apply for the program must meet the same income criteria as citizens and legal residents who qualify for Medicaid. More information on enrollment procedures will be available and community outreach will begin later this year, Guzman said.

“We are making every effort to get this coverage up and running earlier than that. The new program requires changes to the system that determines eligibility, and it takes some time to perform these programming changes,” Munks wrote in an email.

Nearly a year after outreach and enrollment for the initial program in December, nearly 7,000 seniors 65 and older have been enrolled and as of June it has cost the state $60 million, according to data from the Illinois Department of Health Care and Family Services.

Guzman said the enrollment surpassing their initial estimate “has really shown us again that these are people that have been in the shadows of the health care system.”

Although most lawmakers in Springfield have been supportive of the bill, a handful have been vocally against the extension, Guzman said.

One of them was state Sen. Terri Bryant, a Murphysboro Republican, who said in an interview with WJPF radio in July that she did not support the publicity funded health care for immigrants living in the country illegally because Illinois taxpayers are “now responsible for” the extension.

Andrea Kovach, a senior attorney with the Shriver Center on Poverty Law, who has worked with backers of the bill, added that it’s difficult to get an accurate count of the number of undocumented people “because for years, especially the last four years, immigrants have been understandably fearful of answering government surveys or any question that might identify themselves as undocumented.”

Kovach also said that even if the program is costly, the state will save money in the long run by providing preventive care and avoiding sudden and long-term hospitalizations. She also pointed out that a 2017 study found Illinois residents without legal immigration status contributed more than $758 million a year in state and local taxes, which she said debunks the claims that “undocumented don’t pay taxes.”

“We are extremely proud that in 2020, amid a pandemic that disproportionately impacted the elderly, Illinois became the first state to provide Medicaid-like coverage to undocumented older adults aged 65 and over, who would qualify for Medicaid if not for their immigration status,” Illinois Department of Healthcare and Family Services Director Theresa Eagleson said in an emailed statement.

“Under Gov. Pritzker’s leadership, we’re working every day to ensure that in Illinois health care is a right, not a privilege. At HFS, equity is central to our mission, and we’re now working toward launching the extension of these benefits to undocumented older adults aged 55 to 64.”

Cordero said that as she waits to finally enroll, she will work to share the news with fellow immigrants.

“God gave me a second chance by letting me beat breast cancer and allowing me to see my children grow,” she said. “Now I want to make sure that others suffering from an illness also seek resources to see another day.”

larodriguez@chicagotribune.com