10K Illinois noncitizens to lose Medicaid coverage due to federal
changes
[June 11, 2026]
By Peter Hancock
SPRINGFIELD – A bill that will soon head to Gov. JB Pritzker’s desk will
officially remove an estimated 10,000 people from the state’s Medicaid
program, leaving them without any form of health coverage.
That group is made up mainly of people who are not U.S. citizens but who
are in the country legally, according to the Illinois Coalition for
Immigrant and Refugee Rights. That includes refugees and asylum-seekers,
many of whom came to the United States with pre-existing health
conditions.
“If they are enrolled, then they still have Medicaid up until Oct. 1,”
Edith Avila Hesser, ICIRR’s health justice and policy director, said in
an interview. “This adds to the number of uninsured populations that we
have here in the state of Illinois, and so obviously we will be working
to educate this community about the resources that are available to them
through community clinics like FQHCs (Federally Qualified Health
Centers) and free and charitable clinics available throughout the
state.”
Medicaid is a public health coverage program that is jointly funded by
the federal government and the states.
In 2025, Congress amended the federal eligibility rules for Medicaid
with passage of H.R. 1, commonly known as President Donald Trump’s “One
Big Beautiful Bill Act.” It removed eligibility for nearly all
noncitizens except lawful permanent residents, Cuban and Haitian
entrants, and migrants from certain Pacific island nations known as the
Compact of Free Association.
Illinois’ Medicaid bill
In order to comply with that change in federal law, Illinois lawmakers
included language in this year’s annual Medicaid omnibus bill, Senate
Bill 3365, removing most groups of noncitizens from eligibility under
state law.
They include, among others, immigrants who are honorably discharged U.S.
veterans and their families, refugees and asylees, noncitizens
identified as victims of trafficking, Amerasians from Vietnam, and
American Indians born in Canada.
“We had to make that change to comply with H.R. 1 so that we didn’t put
our entire Medicaid program in jeopardy,” Rep. Anna Moeller, D-Elgin,
who chairs the House working group that wrote the omnibus bill, said in
an interview.
Although Illinois also provides health coverage outside the Medicaid
system that is funded entirely with state dollars, the language in this
year’s bill specifically states that it “shall not require any category
of non-citizens or part thereof to be funded at state-only cost.”
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State Rep. Anna Moeller, D-Elgin, speaks on her Medicaid bill on the
House floor on May 31, 2026. (Capitol News Illinois photo by Jerry
Nowicki)
For example, in 2020, Illinois launched a program to provide
Medicaid-like coverage known as Health Benefits for Immigrant Seniors
for noncitizens age 65 and over, regardless of their immigration status.
The following year, it expanded that program with Health Benefits for
Immigrant Adults, which covered adults age 42 to 64, regardless of
immigration status.
But the latter program was closed in 2025 amid budget and political
pressure and enrollment in the seniors program has been limited while
many of its enrollees have been shifted to other subsidized coverage
programs.
Stalled programs
Illinois also participates in a limited program that provides health
benefits to asylum applicants and victims of torture, trafficking and
other serious crimes. And to minimize the impact of the upcoming change
in eligibility rules, immigrant rights advocates introduced legislation
this year to expand that program.
House Bill 4824, sponsored by Rep. Dagmara Avelar, D-Romeoville, and
Senate Bill 3462, sponsored by Sen. Graciela Guzmán, D-Chicago, would
have extended coverage under that program to several additional
categories of noncitizens who are in the country for various
humanitarian reasons. But neither of those bills was ever assigned to a
substantive committee.
Moeller said budget pressures were the primary reason the bills were not
considered this year, and she said that is not likely to change anytime
soon.
“We’re looking at enormous budget pressures next year because of the
cuts in H.R. 1 to the Medicaid program, which is going to affect our
overall budget,” she said. “Hopefully, at some point we can get many of
the provisions that were contained in H.R. 1 overturned federally.”
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