Nationwide Medicaid participation fell 7.6 percent in 2025. Medicaid clients should take steps now to stay enrolled before federal cuts take effect.
Cook County Health (CCH) gathered with leaders from state and local government today to spotlight the potential harm of federal Medicaid cuts and call for a renewed investment in the health care of the 3.2 million Illinoisans enrolled in the program. Leaders encouraged current members to stay connected with the Illinois Department of Healthcare and Family Services (HFS) before changes to Medicaid eligibility take effect by staying enrolled and making sure their contact information is up to date.
House Resolution (HR) 1, also known as the One Big Beautiful Bill Act, was signed into law last July, reducing overall funding for Medicaid and eliminating tax credits for Affordable Care Act (ACA) insurance plans. Among other revisions, the bill mandates new reporting and work requirements for Medicaid clients starting in 2027.
It is estimated that HR 1, also known as the One Big Beautiful Bill Act, will strip Medicaid health coverage from between 190,000 and 360,000 Illinoisans due to work requirements and increased redetermination frequency. Research indicates that these provisions burden states, members and taxpayers with administrative hurdles and create barriers that hinder enrollment, leading to a loss of coverage and pushing individuals deeper into poverty.
“Medicaid is a lifeline for the millions of customers we serve across the state, and the new federal cuts and requirements will very likely drive up the uninsured rate, exacerbate disparities and lead to poorer health outcomes,” said Elizabeth M. Whitehorn, HFS Director. “Many people in our state and across the country now face coverage loss as a result of HR 1, but HFS will continue to fight to protect coverage, minimize harm and champion care for all Illinoisans.”
“Cuts to Medicaid funding threaten our country’s health safety net and could reverse the progress we’ve made on addressing health disparities,” Cook County Board President Toni Preckwinkle said. “Medicaid is a cornerstone of community health, and we can’t let anything prevent people from accessing it because, at the end of the day, these cuts will impact everyone.”
One of the leading public health systems in the nation, CCH also owns and operates Cook County’s largest Medicaid managed care plan, CountyCare. CountyCare has 395,000 members and is the highest-quality Medicaid plan in Illinois, with a four-star rating from the National Commission on Quality Assurance.
Dr. Erik Mikaitis, CCH’s Chief Executive Officer, said after Illinois expanded Medicaid under the ACA, the state’s uninsured population dropped by 44 percent in just one year.
“Medicaid saves lives. This is not an abstract policy issue,” Mikaitis said. “Health coverage can be the difference between timely care and dangerous delays, between prevention and crisis, between survival and loss. We can’t go backwards. All Illinoisans deserve to live healthy lives, no matter their income or insurance status.”
Prior to the passage of HR 1, Medicaid enrollment had already begun to decline nationally, falling 7.6 percent last year. In September 2025 alone, 15,600 fewer Cook County residents were enrolled in Medicaid than in July when HR 1 became law.
Aaron Galeener, Chief Administrative Officer of CountyCare, said plan members have expressed confusion over whether they still qualify for Medicaid, even though most of the provisions in HR 1 have yet to take effect.
“We want Cook County residents to know that if you qualified for Medicaid yesterday, you still qualify for it today,” Galeener said. “We will share information about any changes to your eligibility or new requirements to keep your coverage. Enrollees should renew their Medicaid plan as they have in the past, schedule primary and preventive care, and fill their prescriptions.”
CCH leaders also reaffirmed their commitment to the organization’s historic mission of providing care to anyone who walks through its doors, regardless of insurance, immigration status or ability to pay. However, Mikaitis warned that the health system can only do so much.
“At Cook County Health, we believe health care is a human right,” Mikaitis said. “We care for all patients who come to us in need. We continue to reiterate that we will do as much as we can for as long as we can, but our resources are finite. There may come a time when tough choices have to be made.”
For more information about Medicaid and to sign up, visit healthchoice.illinois.gov.