The “sanctuary” state of Illinois allocated more money in its 2025 budget to cover free healthcare for illegal immigrants than it did for the state’s road repair fund, home-delivered meals for the elderly, expanding foster homes, and the arts, combined.
A Washington Examiner analysis of the state’s budget, put forth in state Senate Bill 251 last year, revealed that the state put $629 million toward taxpayer-funded healthcare for illegal immigrant adults from July 1, 2024, through June 30, 2025.
That single expenditure was more than the $400 million the Illinois Department of Transportation was given for its Road Fund that pays for transportation-related projects in towns, cities, and counties; $55.3 million to cook and deliver meals to the elderly; $22.1 million to increase foster homes and specialized care of children; and $24.6 million to fund the Illinois Arts Council — combined.
Jessica Vaughan, director of policy studies for the Center for Immigration Studies in Washington, said programs like Illinois’ incentivize illegal immigration and take away from other deserving programs.
“It is directly impacting taxpayer money that is available for other people in Illinois, for needy people in Illinois,” Vaughan said in a phone call Wednesday. “States have to balance their budgets, unlike the federal government, so when these costs of services to illegal aliens explode, as has happened with the population of people in the country illegally, generally, then that directly takes away from programs that serve Americans.”
In 2020, Illinois politicians moved to make healthcare coverage available for people who had no legal basis to be in the United States. In December 2020, the state rolled out the Health Benefits for Immigrant Seniors program to give adults over 65 years of age a government-subsidized way to obtain healthcare at low to no cost. People who are unlawfully present in the U.S. are not eligible for coverage under Medicaid.
In May 2022, the program was expanded to include adults between the ages of 55 and 64. Then in July 2022, adults 42 to 54 years old became eligible. Both groups under 65 years old were wrapped into a new program, Health Benefits for Adults.
Between 2021 and 2024, Illinois spent $1.6 billion covering healthcare costs for illegal immigrants over the age of 42, according to a February 2025 report by the auditor general.
The massive spending was due, in part, to the state’s allowing approximately twice as many people to get covered as it had planned for. Around 30,000 illegal immigrants in Illinois were covered by the state plan.
For the fiscal 2026 budget, which began in July this year, Pritzker said the state would no longer be paying for healthcare for illegal immigrant adults — only elderly illegal immigrants who were 65 years old or above.
The state’s Department of Human Services dropped the budget by $330 million by cutting the Health Benefits for Immigrant Adults program. As of July 1, only senior citizens in the country illegally would be eligible for healthcare coverage.
Despite canceling one of the two healthcare programs for illegal immigrants, Illinois had already hit a $200 million deficit by the end of September, just a quarter of the way into fiscal 2026, according to the Governor’s Office of Management and Budget.
Thirteen other states and Washington, D.C., also provide healthcare to illegal immigrants: California, New York, Washington, New Jersey, Oregon, Massachusetts, Minnesota, Colorado, Connecticut, Utah, Rhode Island, Maine, and Vermont.
Vaughan said healthcare programs for illegal immigrants “can serve as a reason that these people don’t go home,” knowing that their healthcare in blue states is better than in the country they are from.
Immigrant advocates have argued that the healthcare program was beneficial.
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For example, the Embodying Race(ism) Project at the University of Chicago determined that the programs coincided with a roughly 15% drop in “bad debt” by Illinois hospitals, meaning that because more people were covered by the state programs, hospitals were not forced to take on the cost of services themselves.
“Notably, we did not observe similar reductions in Wisconsin and Indiana, our control states, suggesting that these changes may have been linked to the implementation of HBIA/HBIS,” the Embodying Race(ism) Project’s website states.
