Cook County Health to Increase Access to Care for Uninsured Residents

The Cook County Health & Hospitals System (CCHHS), with support from Cook County Board President Toni Preckwinkle and Commissioners Bridget Gainer, Jesús "Chuy" Garcia and Robert Steele and the county wide Healthy Communities Cook County (HC3) Coalition, intends to launch a coordinated health program for uninsured individuals who live in Cook County.

“The Affordable Care Act has been instrumental in providing new insurance opportunities to more than 16 million Americans. Yet, there are still too many people in our community who remain uninsured.  Such a coordinated health program will improve access to care for uninsured Cook County residents and reinforce Cook County Health & Hospitals System’s 180-year-old mission to care for all, regardless of ability to pay,” said Cook County Board President Toni Preckwinkle.

CCHHS has long-offered financial assistance services to patients who do not have the means to pay for care. Last year, CCHHS provided more than $400 million in uncompensated care. CCHHS’ current financial assistance program, CareLink, offers discounts on medical care through a sliding scale based on a patient’s income to individuals who are uninsured or not able to afford their commercial insurance deductibles. The program has nearly 40,000 enrollees.

Uninsured individuals have quantifiably poorer health compared to their insured peers. More than 50% of uninsured report having no usual source of health care. Without regular physician visits, an uninsured individual is more likely to have undiagnosed or undertreated chronic diseases (like high blood pressure or diabetes), to be diagnosed with later stage diseases and with diseases known to be preventable with effective screening,  and to die earlier than an insured person.

“Health care is a human right. A person should be able to receive the necessary proactive medical care they need to live a healthy life and not have to only rely on emergency care when they are acutely ill,” said CCHHS CEO, Dr. Jay Shannon. “We see the impact the lack of health coverage has on people every day in our health system. We see it when a patient comes to us with uncontrolled diabetes and requires an amputation, or advanced stages of breast or colon cancer; conditions that could have been identified quickly in a primary care setting and treated early, preventing unnecessary suffering and cost.”

CCHHS has seen a significant decrease in the number of uninsured patients from nearly 55% in 2013 to 32% in 2015 since the adoption of the ACA. Still, nearly one in three CCHHS patients remain uninsured.

A coordinated health program will provide eligible residents with a membership card, member handbook and an assigned “medical home,” and primary care physician at one of CCHHS’ community health centers where they can receive consistent primary and specialty care at any CCHHS facility. All Cook County residents who earn up to 200% of the Federal Poverty Level (FPL) and are not otherwise eligible for public insurance will be eligible for the program. 

The idea for the program was conceived by CCHHS in collaboration with Commissioners Gainer, Garcia and Steele and the Cook County Health Care Task Force that was established by President Preckwinkle and Cook County Board of Commissioners in January 2016 which includes a coalition of community partners, HC3.

“We cannot have a healthy economy or a healthy city without a healthy workforce,” said Commissioner Gainer (D-Chicago). “That means having strong primary and preventive care – not just an emergency room. Cook County Hospital and this new direct access program will make this a reality for families and workers across Cook County.”

"This program will be critically important for people who do not have access to medical care due to their lack of insurance.  Many of them may have been forced to rely on local emergency departments for their health care, a practice that is expensive and can lead to fragmented care and poorer outcomes,” said Commissioner Garcia (D-Chicago).

“I know firsthand how important health insurance is, especially when you are faced with managing a long-term chronic illness,” said Commissioner Steele (D-Chicago). “This program will help thousands of people in our community access important primary care so they can protect their health and wellbeing.”

An estimated 900,000 people in Illinois (a majority of whom live in Cook County) remain uninsured because they are unable to afford commercial plans despite employer or federal subsidies, because they have not yet been enrolled in a public health plan for which they are eligible, or because of their immigration status. 

"The HC3 coalition has been working for more than two years to address the pressing health care needs of the uninsured,” said HC3 member and SWOP community organizer Maggie Perales.” We organized our communities from the city and suburbs and engaged hundreds of uninsured county residents to create a vision for a program that would provide comprehensive health care access to those without insurance. Today, we are thrilled that the needs of our community leaders have been heard and have led to the establishment of this new program. We look forward to continuing to partner with CCHHS and our county commissioners to ensure all Cook County residents have access to the affordable health care services they need and deserve.”

"I am here today because I know that the new CCHHS direct access program that the HC3 coalition, President Preckwinkle and our county commissioners helped create, will give uninsured Cook County residents a better opportunity to get their illnesses diagnosed and treated than I had. I suffered a leg amputation and other diabetes related complications because I could not afford regular health care, but now thousands of county residents will be assigned a medical home and will now have access to affordable preventative health care on a regular basis," said HC3 member, Access Living community leader, and CCHHS patient Jose Manuel.

The Cook County Board of Commissioners’ Workforce Committee will consider an ordinance establishing a coordinated health program (also referred to as a direct access program) on September 14 that will be referred to the full Board the same day.

Following County Board approval, CCHHS will develop an operational structure for the coordinated health program as well as a transition plan for current CareLink members and other eligible patients to enter into the new program beginning in early 2017.

Successful coordinated health programs for the uninsured have been established in many metropolitan areas, including Los Angeles, San Francisco, and Washington D.C.