The recent federal government shutdown caused nationwide disruptions in public services and assistance across many domains, including food and nutrition supports for low-income individuals and households (see Federal Shutdown Threatens Food Assistance for Illinois Families). For the nation’s 41+ million participants in the Supplemental Nutrition Assistance Program (SNAP), the shutdown highlighted their vulnerability to unexpected decreases in monthly benefits. Indeed, SNAP participants…
Each fall, the Governor’s Office of Management and Budget (GOMB) issues its Illinois Economic and Fiscal Policy report, which serves as the State of Illinois’ (Illinois or the ‘State’) primary long-term fiscal planning document and an early indicator of whether Illinois is structurally balanced heading into the next budget year. The 2025 edition of the report, released on October 9, 2025, about a month earlier than required by statute, signals an increasingly strained fiscal environment due to…
Over 41 million individuals rely on the federal Supplemental Nutrition Assistance Program (“SNAP”) to assist in buying food each month—including nearly 1.9 million individuals in Illinois. The current federal government shutdown threatens the funding of these benefits in the near term, and soon-to-be-implemented programmatic changes in federal policies present additional fiscal challenges to states across the country, not to mention budget pressures on SNAP participants. These…
On July 4, 2025, President Trump signed into law a major budget reconciliation bill that significantly reduces federal Medicaid spending, surpassing the cuts proposed in the House version passed in May. In Illinois, the law is expected to result in a $48 billion (20%) reduction in federal Medicaid funding over ten years. The state anticipates millions in administrative costs to comply with the new mandates, and state officials estimate that roughly 330,000 Illinois residents will lose Medicaid…
Over 3.4 million Illinois residents were enrolled in Medicaid healthcare coverage in Fiscal Year 2024 (FY2024). Of those, 44% were children, 9% seniors, and 7% adults with disabilities. Of those 3.4 million, over 772,000 (23%) are adults who received coverage through the Affordable Care Act.
A comparative analysis of state expenditures finds that Illinois allocates a larger portion of its operational expenditures to pension obligations than most peer states. Illinois’ annual expenditures on state-level public pensions totaled nearly $12.2 billion, or approximately 11% of Illinois’ total operational expenditures, based on FY2023 national data. This substantial allocation surpasses that of nearly all 12 peer states used for comparison, as well as the national average. This…
UPDATE: In the final hours of the lame duck session on January 13, the Illinois General Assembly passed legislation providing for spending up to $150 million annually through fiscal year 2027 to modernize safety net hospitals. Senate Bill 1510, as amended, is similar to the transformation funding proposal described below by the State’s Medicaid agency. A new provision would allow for the creation of a category of safety net institutions that would be eligible for priority funding. Last May the…
UPDATE: On September 21, the Cook County Health (CCH) Board approved by a vote of eight to three an amended FY2021 proposed budget with $40 million of additional County funding, instead of the $53 million in the September 11 version. That amounts to $10 million more than the $30 million increase originally approved by County Board President Toni Preckwinkle’s office, but it is less than the $23 million addition in the CCH Board’s September 11 budget proposal. President Preckwinkle’s office…
Cook County’s public health system has sounded an alarm about the increasing cost of services for which it does not receive reimbursement, saying that Cook County Health will not be able to fulfill its mission of providing care to all—regardless of ability to pay—if the trend continues. Cook County Health expects to provide $544 million of uncompensated care in the current fiscal year, which ends on November 30, 2019. That represents an increase of more than 8% from $502 million in FY2018 and…
A key Illinois Medicaid panel has recommended that the State move away from costly and often ineffective hospital detoxification services to treat opioid addiction. The Medicaid Advisory Committee on August 2 urged the State’s Medicaid agency to revise its reimbursement practices to discourage traditional hospital detox stays and provide financial incentives for evidence-based care such as medication-assisted treatment. The panel also recommended that the Illinois Department of Healthcare and…
