How many Illinoisans could lose health coverage under the House Republican plan?
- Up to 714,000 Illinoisans in the Medicaid expansion population could lose coverage due to new work requirements.
- An additional 45,000 Illinoisans may lose Affordable Care Act (ACA) marketplace coverage due to higher premium costs.
How would the plan raise health insurance costs in Illinois?
- The bill ends enhanced premium tax credits that help low- and middle-income families and small business owners afford coverage.
- For example, a 60-year-old couple earning $82,000 could see their annual premiums increase from $6,970 to over $24,158.
- Without these subsidies, many may be forced to forgo insurance altogether.
- Cuts would significantly increase uncompensated care costs for hospitals and providers, leading to higher costs for all patients to offset. Furthermore, reductions in funding will disproportionately impact rural hospitals, possibly leading to closures.
What new barriers would Illinoisans face in accessing Medicaid?
- The plan adds harsh work requirements to Medicaid, creating more red tape and bureaucracy.
- Many people — including those who are working — could lose coverage simply due to paperwork or procedural issues.
- These requirements have proven ineffective in increasing employment but highly effective in cutting people off from health care.
How does the proposed plan affect immigrants’ access to health care in Illinois?
- This bill targets access to health care for immigrant communities in several ways, including punishing states that use their own funds to provide coverage for immigrants.
- If enacted, the bill would force Illinois lawmakers to choose between covering adults in the medicaid expansion or covering immigrant seniors and children.
- The plan also targets people who do not meet the narrow federal definition of a “qualified” immigrant, which includes many people who are in the US legally.
Could Illinois lose federal Medicaid funding under this plan?
- Yes. If Illinois continues to cover undocumented children and adults, as well as some individuals with lawful statuses who are no longer deemed “qualified,” the federal match rate for Medicaid expansion would fall from 90% to 80%.
- This would cost the state $5.1 billion in lost federal funding between now and 2034.
- Under current state law, this cut could automatically trigger the end of Medicaid expansion, unless the state legislature intervenes.
What choices would Illinois lawmakers be forced to face as a result of these health care changes?
- The state would be forced to cut coverage, raise taxes, or reallocate funds away from schools, infrastructure, or other services to make up for the shortfall.
- These decisions could lead to more uninsured residents, greater strain on hospitals and providers, and increased uncompensated care costs across the state.
Source: Center on Budget and Policy Priorities Illinois Fact Sheet, May 29, 2025
