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Cook County CEO Jay Shannon: ACA repeal a threat to public health—and the public system's financial health

Monday, April 17, 2017
Fierce Healthcare
by Paige Minemyer

The Republican Party’s path forward on healthcare reform remains unclear, but leaders at organizations that benefited most from the Affordable Care Act still worry about repeal.

Jay Shannon, M.D., the CEO of Cook County Health and Hospitals, told the Associated Press that it's the top public health concern for the public system—which treats large numbers of low-income patients—because it “has been such a leg up” for people who were previously unable to get insurance.

Jay Shannon

Before the law’s provisions were fully in place in 2014, the Chicago-based system’s patient population was 70% uninsured. Now the trend is reversed, about just 30% are uninsured, which Shannon said is almost entirely thanks to Illinois’ decision to expand Medicaid under the law.

RELATED: Medicaid expansion slashed uninsured rates for poor, childless adults

The increase in Medicaid patients has been a significant financial boon for the system. It’s seen revenue increase between $200 million and $300 million each year since 2014. And though emergency room visits have not decreased overall, the system is seeing fewer visits for conditions that would be better treated through primary care or urgent care.

“The health system has been able to break even for the first time in our history,” Shannon said. “We always operated at a gigantic loss.”

Cook County is just one health system closely monitoring the GOP’s next move on healthcare. Their first attempt to repeal and replace the ACA, the American Health Care Act, was widely panned by provider groups, including the American Hospital Association and the American Medical Association. The AHA launched a campaign urging its members to stand against the proposal, which would have slashed Medicaid funding and significantly increased the number of people without insurance.

The number of people that would likely lose insurance under the law was a particular sticking point for these groups. Hospitals made notable financial gains under the ACA because of the reduction in uncompensated care costs. Estimates have projected that uncompensated care costs could increase by more than $1 trillion over the next 10 years if the ACA is repealed.

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