State lawmakers and policy advocates say they have yet to see the numbers the department uses to justify exclusions. “They told us it was too expensive,” said State Rep. Delia Ramirez, the lead co-sponsor of the legislation that created the immigrant adult health benefit program.

But advocates say the cost is well worth it. Research shows that primary care for older adults who visit illegally can reduce the number of emergency room visits, which are inevitably paid for by the state or charitable reserves of hospitals and health systems.

“If we don’t spend $100 million on undocumented seniors (health care), it’s not like the state is saving $100 million. If we cut programs tomorrow, those costs are still there. It’s just cost shifting. Absorb those costs,” said Andrea Kovacs, a senior attorney at the Shriver Poverty Law Center.

“(Undocumented) seniors are still getting sick. They’re still having accidents,” she said.

Last year, state lawmakers successfully expanded the program to undocumented immigrants between the ages of 55 and 64. Last month, Ramirez introduced a bill that would expand Medicaid coverage for noncitizen immigrants 19 and older who meet the program’s income requirements. The proposal, “Healthy Illinois for All,” would cover nearly 150,000 low-income immigrants who don’t qualify for the state’s Medicaid program, according to the Shriver Poverty Law Center. (The state already provides health care to low-income children under 18, regardless of immigration status.)

Ramirez, who ran for Congress this year, said she and her colleagues behind the plan are working to get the Department of Health Care and Family Services to fill the gaps in the plan for seniors. “We’ve made it clear to HFS that we want to include (exclude services) when we roll out our next plan,” she said.

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Start where the country stops

As state lawmakers work to fill gaps in programs for undocumented seniors, community groups, family members and volunteers seek to provide moral, material and financial support that agencies and government agencies do not. But hanging over them is a demographic bubble that they say will make them thin and leave too many older people behind.

“We need to prepare for this,” said Enrique Jimenez, program director at the Latino Alzheimer’s and Memory Impairment Alliance (LAMDA) in Chicago. “We need better programming, better outreach and resources for these people because they’re not going anywhere.”

The coalition serves more than 100 seniors with memory impairment and more than 300 caregivers from Chicago and nearby suburbs. Many patients and caregivers are undocumented, Jimenez said. The alliance offers recreational programs for seniors, such as karaoke and Zumba classes, and trains caregivers on how to manage illness.

“It really disrupts the whole family and their quality of life. It’s like a domino effect after the disease is discovered,” said Constantina Mizis, the group’s co-founder. “Sometimes carers of loved ones have to leave work to care for them, which can lead to financial hardship, which can lead to more stress and trauma. It’s a family disease.”

Jimenez and Mizis applaud the creation of the Adult Immigrant Health Benefit program. But as the population they serve grows each year, Jimenez worries about the league’s ability to keep pace. “We already need more resources to serve better and provide more resources for seniors and their families. I’m concerned that as the population grows, we won’t have enough money,” he said.

Although several organizations and nonprofits, such as LAMDA, provide resources for these growing populations, many undocumented immigrants are afraid to seek help because they fear deportation, or because of language and technical barriers. Instead, many immigrants without proper documentation, such as Burgos and Ocampo, seek out and create communities for each other, help each other look after each other, find jobs, pay off debts, and generally look after each other.