Illinois received a late Christmas present on Tuesday when the U.S. Department of Health and Human Services announced that the Land of Lincoln was one of 15 states to earn a bonus Medicaid payment. The reason? The state has made significant progress in enrolling uninsured children in Medicaid. Health officials still have not decided how they plan to use their performance award, which totals $14.9 million.

To their credit, Illinois officials have been aggressive in their efforts to streamline enrollment and connect eligible children with medical services from which they can benefit. Indeed, a new state law that goes into effect Saturday ends a requirement that a child be booted from the All Kids program for at least three months if his or her guardian misses a premium payment. But with budget hawks circling the capitol dome, public health is in the cross-hairs. The Medicaid reform committees that held hearings this month, for instance, both discussed tightening the process for checking a child’s eligibility. While there are some Medicaid changes that make sense, lawmakers should be cautious about making it more difficult for the poor to access care. Doing so could endanger federal support and the health of Illinois residents.