FOR IMMEDIATE RELEASE: WEDNESDAY, MAY 7, 2025
FOR MORE INFORMATION: LAURIE R. GLENN | 773.704.7246 | lrglenn@thinkincstrategy.com
CHICAGO — A new study from the University of Chicago’s Embodying Race(ism) Lab suggests that expanding access to healthcare for underserved immigrant populations in Illinois may also help ease financial pressures on hospitals.
Preliminary results show that after the launch of Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors (HBIS) programs, hospital bad debt declined by an average of 15% statewide. HBIA and HBIS are state-funded programs that provide health insurance to approximately 40,000 older adults and seniors who are excluded from federal health insurance programs due to their immigration status.
The research provides one of the first quantitative evaluations of HBIA/HBIS’s financial impacts. Led by a multidisciplinary team of public health, economics, and policy experts and supported by policy advocates, including Healthy Illinois, the study sheds light on how inclusive health coverage may influence hospital operations across the state.
Using hospital financial data from 2017-2023, the study points to the potential benefits of expanding preventative care access beyond the immediate impact of the HBIA/HBIS programs. From 2017-2020, Illinois hospitals incurred an average of $10.3 million in bad debt annually – a 15% reduction based on research estimates translates to an average savings of about $1.5 million per hospital each year (although not all hospitals or counties are equally impacted by HBIA/HBIS).
“Illinois has demonstrated that inclusive healthcare policies can deliver measurable returns for patients and providers alike,” said Dr. Arturo Vargas Bustamante, Professor at UCLA’s Fielding School of Public Health and a collaborator on the study.
The findings come at a critical moment. On May 9, the Illinois Joint Committee on Administrative Rules (JCAR) will consider emergency rule changes that could eliminate coverage for over 33,000 low-income immigrants enrolled in HBIA.
Healthcare systems, especially those that serve publicly insured and low-income patients, have long operated with thin margins and rising uncompensated care burdens. Anecdotal accounts suggest that HBIA/HBIS programs have provided welcome financial relief for many hospitals in Illinois that serve large immigrant populations. A sudden reversal in coverage could increase uncompensated care—especially for safety-net institutions—and may impact services for all patients.
“Illinois led the nation by boldly extending health coverage to immigrants excluded from our healthcare system,” said Dr. Aresha Martinez-Cardoso, assistant professor and principal investigator of the Embodying Race(ism) Lab. “Our early findings show that this landmark policy isn’t just about access — it also serves as a strategic investment in our hospitals and the health of entire communities.”
STUDY DETAILS AND FINDINGS
The University of Chicago research team used publicly available hospital financial reports to analyze changes in uncompensated care between 2017 and 2023. Uncompensated care refers to the cost of hospital services for which no payment is received from patients or insurers– a financial strain that can lead to reduced operating margins, staff cuts, or diminished patient services.
The study compared changes in uncompensated care in Illinois to neighboring states, Indiana and Wisconsin, before and after the launch of HBIA/HBIS. In addition, the study compared Illinois counties across levels of HBIA/HBIS enrollment, offering a more targeted look at financial impacts.
Although analysis is ongoing, the researchers used standard methods to assess the robustness of their findings, including accounting for differences in hospital characteristics, county demographics, and time trends. These approaches have been used in similar studies that examined the effect of other insurance expansions, such as the Affordable Care Act.
“What this data illustrates is the structural role that access plays in determining both community health and institutional stability, in particular as immigrants age,” said Angela Garcia, an Associate Professor at the University of Chicago Crown School of Social Work, who reviewed the findings. “When access is expanded, systems work better — for patients, for hospitals, and for society at large.”
A full copy of the report, along with accompanying materials, is available at:
https://erlab.uchicago.edu/research/hbiahbis
ABOUT THE EMBODYING RACE AND RACISM LAB
The Embodying Race(ism) Lab at the University of Chicago uses social science and public health methods to study how social inequality in the US shapes health. Dr. Aresha Martinez-Cardoso is the Lab’s principal investigator and an assistant professor at the University of Chicago Department of Public Health Sciences. For more information go to lab’s website https://erlab.uchicago.edu.