Pritzker warns 330,000 Illinoisans could lose Medicaid under Trump’s
budget plan
[July 05, 2025]
By Peter Hancock
SPRINGFIELD — The U.S. House gave final passage Thursday to a budget
bill that will cut federal Medicaid spending by an estimated $1 trillion
over 10 years.
All three Republican members of the Illinois congressional delegation
voted in favor of the bill, despite a last-minute plea from Democratic
Gov. JB Pritzker who warned the bill will result more than 330,000
Illinoisans losing Medicaid coverage and have a devastating effect on
some rural hospitals.
“As those who are entrusted with protecting the health of all your
constituents, I urge you to oppose these harmful Medicaid provisions and
work to protect healthcare access for rural Illinois families, workers,
and veterans,” Pritzker wrote in the letter addressed to GOP Reps. Mike
Bost, Darin LaHood and Mary Miller.
The cuts would translate to about $48 billion in Illinois over that
period, or about 20% of what the state would otherwise receive,
according to an analysis by KFF, a nonpartisan health policy research
organization.
That would be one of the largest percentage reductions in any state in
the nation, according to KFF, a nonpartisan health policy research
organization formerly known as the Kaiser Family Foundation. Louisiana
and Virginia would each see cuts of about 21%, KFF said.
The state-level analysis is based largely on Congressional Budget Office
estimates showing the bill would reduce federal Medicaid spending by $1
trillion nationwide over the next decade.
The KFF analysis does not include estimates of the number of people who
would lose Medicaid coverage under the bill, noting how that will depend
on how individual states respond to the policy changes contained in the
bill. But overall, it estimates the number of uninsured Americans will
grow by 11.8 million.
The bill, which includes many of President Donald Trump’s domestic
policy priorities – including tax cuts and increased spending on border
security – passed the Senate on Tuesday by a vote of 51-50, with Vice
President J.D. Vance casting the tie-breaking vote. Both senators from
Illinois, Democrats Dick Durbin and Tammy Duckworth, voted no.
The final vote in the House was 218-214.
“The One Big, Beautiful Bill is a once-in-a-generation victory for the
American people,” Miller said in a statement after the House vote. “It
delivers on President Trump’s America First agenda with bold, decisive,
and immediate action. This is the most pro-worker, pro-family,
pro-America legislation I have voted for during my time in Congress, and
I was proud to help get it across the finish line for the hardworking
Americans across my district.”
Medicaid and the health care marketplace
Medicaid, which is jointly funded by states and the federal government,
provides health coverage for lower-income individuals and families. It
was established in 1965 alongside Medicare, the federally funded health
coverage program for people over 65.
Today, according to the Illinois Department of Healthcare and Family
Services, the program covers about 3.4 million people in Illinois, or a
fourth of the state’s population. At a total cost of $33.7 billion a
year, it is one of the largest single categories of expenditures in the
state’s budget. It pays for about 40% of all childbirths in the state,
according to KFF, as well as 69% of all nursing home care.
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President Donald Trump raises his fist at the Republican National
Convention in Milwaukee last year alongside U.S. Rep. Steve Scalise
(left) and then-running mate J.D. Vance (right). His largest
domestic policy bill, which makes drastic cuts to Medicaid, appeared
poised to become law this week. (Capitol News Illinois photo by
Andrew Adams)
But questions about its future loomed over the Illinois General Assembly
during the just-completed legislative session as both Congress and the
General Assembly were crafting their respective budgets for their
upcoming fiscal years.
“This was a difficult year because of the unprecedented changes and cuts
that are looming on the horizon in Washington,” state Rep. Anna Moeller,
D-Elgin, said on the floor of the Illinois House during debate over a
Medicaid bill on the final day of the session.
Speaking with reporters at an unrelated event Tuesday, Pritzker
predicted “hundreds of thousands” of people in Illinois will lose
Medicaid coverage if the Senate bill is signed into law.
“This is shameful, if you ask me, and it’s going to be very hard to
recover,” Pritzker said. “The state of Illinois can’t cover the cost –
no state in the country can cover the cost of reinstating that health
insurance that is today paid for mostly by the federal government,
partly by state government.”
Policy changes under the bill
According to KFF, most of the reductions in Medicaid spending would
result from just a few policy changes contained in the bill
Those include imposing a work requirement on adults enrolled in Medicaid
through the Affordable Care Act, also known as “Obamacare.” That law
expanded eligibility for Medicaid to working-age adults with incomes up
to 138% of the federal poverty level. About 772,000 people in Illinois
are enrolled under that program.
The bill also calls for requiring people enrolled through the ACA
expansion to verify their continued eligibility for Medicaid twice a
year instead of annually. That is expected to filter out enrollees whose
incomes rise above the eligibility limit as well as those who simply
fail to complete the verification process.
Another provision would limit the ability of states to finance their
share of the cost of Medicaid by levying taxes on health care providers.
Illinois imposes such taxes on hospitals, nursing facilities and managed
care organizations that administer the program. Revenue from those taxes
is used to draw down federal matching funds that are then used to fund
higher reimbursement rates to health care providers.
The final version of the bill does not, however, include a provision
penalizing states like Illinois that also provide state-funded health
care to noncitizens who do not have lawful status to be in the United
States. That provision, which was included in the earlier House version,
was not included in the Senate bill, according to KFF.
Capitol News Illinois is
a nonprofit, nonpartisan news service that distributes state government
coverage to hundreds of news outlets statewide. It is funded primarily
by the Illinois Press Foundation and the Robert R. McCormick Foundation. |
