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Preckwinkle: Proposal To Replace Obamacare Might Cost Cook County Nearly $300 Million

The head of the Cook County Board said if the Affordable Care Act is dismantled it could mean the loss of hundreds of millions of dollars in federal funding. Board president Toni Preckwinkle said Cook County has a long history of providing care to those with little to no health insurance, but that 500,000 people in the county could lose healthcare coverage if Obamacare is eliminated.

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Toni Preckwinkle

Cook County Board President Toni Preckwinkle speaks during an interview with the Associated Press in Chicago Nov. 23.

M. Spencer Green

Cook County could lose nearly $300 million in federal funding if House Republicans go through with their plan to dismantle parts of the Affordable Care Act, county officials said Wednesday.

Democratic Cook County Board President Toni Preckwinkle said that county taxpayers provided about $400 million a year for the Cook County Health and Hospitals System in 2010. Much of that went to providing care to people with little to no healthcare coverage.

Since the passage of the Affordable Care Act, the county’s contribution has dropped to $111 million. But those savings could be lost if the ACA, also known as Obamacare, is eliminated under the plan put forth by House Republicans, Preckwinkle said.

Preckwinkle said nearly 500,000 people in the county could lose health care coverage if the GOP plan is approved. She said about 350,000 residents got coverage from the ACA’s expansion of Medicaid, the health care system for the poor, and another 150,000 got coverage on the insurance marketplaces.

“Essentially, they want to eliminate the Medicaid expansion part of the Affordable Care Act,” Preckwinkle said. “The ACA, especially the Medicaid expansion component, has been a Godsend to tens of millions of Americans. These are real people, many of whom who were underserved or unserved by traditional health insurance prior to ACA.”

Preckwinkle said counties all over the country are worried about what losing the ACA will mean in terms of dollars lost and people losing coverage.

“What we’ve seen from the U.S. House of Representatives will result in fewer people having access to healthcare coverage, especially those who rely on expanded Medicaid,” Preckwinkle said following Wednesday’s County Board meeting. “We can only hope that sanity prevails in the upcoming debate. Thirty-one states have expanded Medicaid under the ACA, 17 of them lead by Republican governors.”

The proposed GOP bill would overhaul the framework of Medicaid and end its open-ended federal financing. Starting with the 2020 fiscal year, each state would receive a limited, per-beneficiary amount based on enrollment and costs.

States would gain flexibility to cap enrollment and change benefits. Federal payments would be increased according to a measure of medical inflation.

Dr. Jay Shannon, CEO of the Cook County Health and Hospital Systems, said using this payment scheme -- known as block grants -- is especially problematic for Illinois. That’s because 2016 would be used as a baseline year to establish how much the county would get going forward, Shannon said.

“Illinois (is) the lowest, it is the 50th out of 50 states in spending per Medicaid enrollee. It also has the lowest federal match into the Medicaid program,” Shannon said. “We’re starting from the position of disadvantage. The proposed model is not a good one for Illinois.”

Preckwinkle said she has contacted Illinois’ congressional delegation to see about protecting the ACA. She also said she had spoken with Republican Gov. Bruce Rauner, who has voiced his own reservations about plans to scale back Obamacare.

Even if the county loses its Medicaid funding, she said it will continue to provide healthcare coverage to those who are uninsured or underinsured. But she didn’t say how the county would cover the hundreds of millions of dollars in lost federal funding.

“That’s a wonderful legacy and we’re not going to turn our backs on our legacy,” Preckwinkle said. “We will continue to provide the care that we’ve always provided. We’ll have to figure out another way to do it.”

The Associated Press contributed to this story.

Michael Puente covers Northwest Indiana for WBEZ. Follow him on Twitter at @MikePuenteNews.

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