<span class="field field–name-title field–type-string field–label-hidden">Illinois Faces Looming Health Crisis as Medicaid Cuts Threaten Coverage, Hospitals and Rural Access</span>
<span class="field field–name-uid field–type-entity-reference field–label-hidden"><span>Jared Rutecki</span></span>
<span class="field field–name-created field–type-created field–label-hidden"><time datetime="2025-08-06T05:00:00-05:00" title="Wednesday, August 6, 2025 – 05:00" class="datetime">Wed, 08/06/2025 – 05:00</time>
</span>
<div class="clearfix text-formatted field field–name-body field–type-text-with-summary field–label-hidden field__item"><p><img class="image-full non-gallery-image" src="/sites/default/files/styles/full/public/article/image-non-gallery/MountSinai_Hospital_FINAL_Credit_Michael_Izquierdo_%40izqueerdo-5%281%29.jpg?itok=r3tgbfEQ" data-entity-uuid="insert-full-09127d61-055f-48ac-b4eb-72acdf3f451f" data-entity-type="file" alt="Mount Sinai Hospital, 1500 S. Fairfield Ave., Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)" width="1920" height="1230" title="Mount Sinai Hospital, 1500 S. Fairfield Ave., Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)">
</p><p>Medicaid cuts enacted by a sweeping federal rescission bill are sounding alarms for Illinois health professionals, who warn the move could gut insurance coverage, strain already overburdened hospitals and deepen access issues in rural Illinois and across the state.</p>
<p>Reductions to Medicaid, a public health insurance program for families and individuals with low incomes and limited resources, are expected to affect services and facilities across the state. Medicaid benefits are often used by middle-class families needing long-term or specialty care. The reduced budget is expected to impact rural and safety net hospitals.</p>
<p>The legislation also made significant cuts to programs including <a href="https://ift.tt/Ju2p1Nn" target="_blank">foreign aid</a>, <a href="https://ift.tt/H3MvsAB" target="_blank">public broadcasting</a> and <a href="https://ift.tt/IxYe865" target="_blank">health care</a>.</p>
<p>Hospitals and medical professionals said the cuts could become a looming health crisis threatening outcomes and accessibility for all patients, crossing political and demographic lines.</p>
<p>The problems would only grow if the cuts lead to hospital closures.</p>
<p>Recent figures estimate <a href="https://ift.tt/FmEqbSh" target="_blank">330,000 Illinois residents</a> could lose health coverage under the plan. Many who spoke with WTTW News said the law will lead more uninsured patients to seek emergency care, often with advanced conditions.</p>
<p>Medicaid covers <a href="https://ift.tt/stmUgFB" target="_blank">more than 3.4 million people</a> in the state including children, seniors and adults with disabilities, according to the Illinois Department of Healthcare and Family Services.</p>
<p>Estimates show 35.6% of Illinois residents <a href="https://ift.tt/mkfFlqv" target="_blank">had public health insurance</a> in 2023, up 2.1 percentage points from 2019, according to data from the U.S. Census Bureau.</p>
<p>Health care leaders are still sorting out exactly what the complex 800-page law means for how they provide care for their patients. The reductions will take place over the next decade, and there will be consequences both short- and long-term, they said.</p>
<p>“What you’re going to see with Medicaid cuts is deeper inequities and higher long-term costs,” Dan Regan, spokesperson at Sinai Chicago, said. “We have worse life expectancies here on the West Side by almost 20 years in some cases than what they have just six miles to the east. The health disparities have the potential to worsen.”</p>
<h3>‘Forced to make difficult decisions’</h3>
<p><img class="image-full non-gallery-image" src="/sites/default/files/styles/full/public/article/image-non-gallery/MountSinai_Hospital_FINAL_Credit_Michael_Izquierdo_%40izqueerdo-7%281%29.jpg?itok=6y6Ac-AM" data-entity-uuid="insert-full-3b688d2f-80f1-4697-9315-c788574613d8" data-entity-type="file" alt="Mount Sinai Hospital, 1500 S. Fairfield Ave., Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)" width="1824" height="1026" title="Mount Sinai Hospital, 1500 S. Fairfield Ave., Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)">
</p><p>The Congressional Budget Office identified a drop of more than $1 trillion in health care spending from the law referred to as the <a href="https://ift.tt/SZrdxzl" target="_blank">One Big Beautiful Bill Act</a>. CBO, which provides nonpartisan information to Congress, projected the bill would increase the number of people without insurance by 10 million in 2034, as well as <a href="https://ift.tt/M3Eha2A" target="_blank">increase the budget deficit</a> by $3.4 trillion.</p>
<p>Reductions will affect programs including Medicaid, Medicare and the <a href="https://ift.tt/5xGegic" target="_blank">Supplemental Nutrition Assistance Program</a>.</p>
<p>In Illinois, cuts are expected to impact some hospitals more than others at first. Safety net hospitals serve a low-income population regardless of their insurance, citizenship or ability to pay.</p>
<p>Sinai Chicago serves patients on the West and Southwest sides of the city through the Mount Sinai, Holy Cross and Schwab Rehabilitation hospitals.</p>
<p>The system operates one of Chicago’s busiest Level 1 trauma centers, Regan said. The hospitals offer a wide range of specialty services including cardiology, behavioral health, digestive health and maternity care.</p>
<p>Estimates provided to the Illinois Department of Public Health show Sinai approaching the state’s highest percentage of net revenue from public insurance. Holy Cross and Schwab both reported more than 93% of revenue in 2024 from Medicaid and Medicare.</p>
<p><iframe style="border-style:none;min-width:100% !important;width:0;" title="Medicaid revenue by hospital in Illinois" aria-label="Table" id="datawrapper-chart-Wl3mo" src="https://ift.tt/NPeEVB2" scrolling="no" frameborder="0" height="1100" data-external="1"></iframe><script type="text/javascript">!function(){"use strict";window.addEventListener("message",function(a){if(void 0!==a.data["datawrapper-height"]){var e=document.querySelectorAll("iframe");for(var t in a.data["datawrapper-height"])for(var r,i=0;r=e[i];i++)if(r.contentWindow===a.source){var d=a.data["datawrapper-height"][t]+"px";r.style.height=d}}})}();</script></p>
<p>About 70% of people receiving inpatient services at Sinai Chicago are Medicaid patients, Regan said.</p>
<p>The three hospitals reported more than half of their revenue comes from Medicaid, and they provided more than $47 million in charity care in 2024, records show.</p>
<p>The slashed budgets <a href="https://ift.tt/IxYe865" target="_blank">will impact schools, businesses and community organizations</a> around the state in addition to the health system, Regan said.</p>
<p>Hospitals have not yet identified the exact path forward to react to the new law. When the payments are reduced, safety net hospitals may be forced to consider some tough possibilities.</p>
<p>“You’re going to be forced to make difficult decisions, where you’ve got to prioritize more limited resources and provide the services that are most critically needed by our communities,” Regan said.</p>
<p>Safety nets will try to maintain their mission to serve everybody regardless of their ability to pay, but they may have to reconsider the geography, Regan said, limiting boundaries to reduce the cost of charity care for the most vulnerable and the most in need.</p>
<p>“Fulfilling our mission puts us directly at odds with the economic reality we face,” Regan said. “What we really need to do is protect Medicaid. Revamp the reimbursement system to better cover the real costs of care, and figure out what are better, more effective funding mechanisms.”</p>
<h3>‘No one plans for kids to get sick’</h3>
<p><img class="image-full non-gallery-image" src="/sites/default/files/styles/full/public/article/image-non-gallery/LaRabida_Hospital_FINAL_Credit_Michael_Izquierdo_%40izqueerdo-3%281%29.jpg?itok=nNOAHwNi" data-entity-uuid="insert-full-433004d1-8731-4af4-8b48-19df632bbccf" data-entity-type="file" alt="La Rabida Children’s Hospital, 6501 S. Promontory Drive, Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)" width="1824" height="1026" title="La Rabida Children’s Hospital, 6501 S. Promontory Drive, Chicago, is pictured on Aug. 4, 2025. (Michael Izquierdo / WTTW News)">
</p><p>Many interviewed by WTTW News said the safety net and rural hospitals would bear the initial pressure created by the new law. Eventually, they expect the changes to strain emergency rooms, delay care and create longer wait times for all patients, including those with private insurance, even at other facilities.</p>
<p>But safety nets, including those that specialize in pediatric care, will be affected first.</p>
<p>La Rabida Children’s Hospital provides care, behavioral health, social work and nutrition services in Woodlawn.</p>
<p>The hospital has fewer than 50 beds, records show. La Rabida said its outpatient clinic also offers family-centered primary care as well as specialty clinics for children and youth with complex medical and developmental needs.</p>
<p>Rolla Sweis, president and CEO at La Rabida, focused on the effect of freezing the Medicaid tax reimbursement rate until the 2028 fiscal year before decreasing it.</p>
<p>“Simply put, this means less money coming in, which will directly impact the services we are able to provide,” Sweis said.</p>
<p>The bill affects the hospital’s ability to treat some of our state’s most vulnerable children, ensuring that a family’s ability to pay does not prohibit them from receiving necessary care, Sweis said.</p>
<p>“No one plans for kids to get sick, and Medicaid provides an essential safety net for all our children,” Sweis said.</p>
<p>Records show La Rabida is among the facilities with the state’s highest percentage of Medicare net revenue. About 90% of La Rabida patients rely on Medicaid, Sweis said.</p>
<p>The primary service area for the hospital is estimated to be entirely above the federal poverty level. The population in Englewood was highest at 42.4%, according to <a href="https://ift.tt/JkrN1tV" target="_blank">the hospital’s Community Benefit Report</a>.</p>
<p>The hospital hopes to continue its mission through new and expanded efforts for direct-giving and private grant support.</p>
<h3>‘An assault on rural life’</h3>
<p>While the impact will be heavily felt by Chicago safety net hospitals, many also expect pressure to manifest in rural health care centers.</p>
<p>Leaders of rural health facilities said policymakers and lawmakers failed to consider what this law does and whom it affects.</p>
<p>“It feels like an assault on rural life, not just health care,” Tracy Warner, executive director of ICAHN, said.</p>
<p>ICAHN, or the Illinois Critical Access Hospital Network, is a nonprofit that provides services for 60 small and rural hospital members.</p>
<p>Rural populations are older and sicker, with higher poverty rates and more limited access to care than the general population. This presents a unique set of challenges for health providers both before and after the new legislation for a population that relies more heavily on government insurance.</p>
<p>The cuts come to areas already experiencing a shortage of primary and specialty care in Illinois.</p>
<p>Warner remained optimistic on some matters, viewing the new law as a chance to look at care models and rethink how those services are being delivered. Providers might explore adding more technology, using ambient listening, telehealth or community partnerships following the Medicaid reduction, she said.</p>
<p>She highlighted the maternal care deserts in rural Illinois, and how cuts might <a href="https://ift.tt/j3ZfdYV" target="_blank">exacerbate the issue</a> of recruiting and retaining staff, or reduced service.</p>
<p>When Illinois added the Medicaid expansion in 2014, the uninsured rate <a href="https://ift.tt/z9PixQf" target="_blank">dropped by about 44%</a>, and the state saw a reduction of $675 million in uncompensated care between 2013 and 2015, according to IDHFS.</p>
<p>Many ICAHN members already operate from a precarious financial position.</p>
<p>“About 25% of our rural hospitals have negative or very thin margins,” Warner said.</p>
<h3>‘Don’t let them off the hook’</h3>
<p>Another point that many agreed upon: the biggest potential impact to Illinois communities would be a hospital closure.</p>
<p>The Sheps Center for Health Services Research at the University of North Carolina <a href="https://ift.tt/tP1FgyU" target="_blank">reported three rural hospital closures or conversions</a> in Illinois since 2016.</p>
<p>Predicting how many hospitals cease operations is a difficult task. But the damage to health and access can be estimated.</p>
<p>“We know dozens of hospitals in the state are vulnerable to closure already,” Michelle Rathman, CEO of Impact Communications, said. “The worst case scenario is that the hospitals close.”</p>
<p>Rathman works with rural hospitals on health strategy and engagement at Impact. She also hosts the “Rural Impact” podcast which focuses on connecting the dots between public policy and rural quality of life.</p>
<p>The Trump administration has highlighted its <a href="https://ift.tt/9Ya1frq" target="_blank">Make America Health Again</a> policy through the U.S. Department of Health and Human Services. Closing rural hospitals could make that goal more challenging, according to Rathman.</p>
<p>“I don’t see how we do that by cutting off access to preventative care,” Rathman said. Transportation and housing access affect people across the country, but the effect is particularly acute in rural areas.</p>
<p>Future reductions in the Medicaid contribution from the federal government could also lead to the end of the Affordable Care Act in Illinois because of the state trigger law, Rathman said. Trigger laws automatically terminate Medicaid expansion in states where the federal matching percentage is reduced below a certain threshold.</p>
<p><img class="image-full non-gallery-image" src="/sites/default/files/styles/full/public/article/image-non-gallery/health-professional-shortage-areas-primary-care-by-county-july-2025-IL%20%281%29.jpg?itok=49hi7qGu" data-entity-uuid="insert-full-24f2ab00-e785-4e9d-88dc-1c9230262313" data-entity-type="file" alt="Map of Illinois counties with health professional shortages. (Credit: Rural Health Information Hub)" width="860" height="607" title="(Credit: Rural Health Information Hub)">
</p><p>Rathman said cuts to loan forgiveness programs and health education centers will reduce the pipeline of health care professionals to rural areas. She also highlighted how “onerous” work and income verification requirements will affect coverage for people who are self-employed or independent contractors.</p>
<p>While the outlook in some places may seem bleak, the opportunity to change course still remains. Rathman urged health leaders with elected officials who voted for the bill to engage them.</p>
<p>“Don’t let them off the hook. Bring them to your community, have them sit and talk with people. Have them understand what that impact is and let them hear those stories,” Rathman said. “Being vocal, and being persistent and consistent with your messaging is going to be really important.”</p>
<p>Warner said the law was passed, “despite objections from many of our members.” She hoped those who depend on these services would weigh in.</p>
<p>“Join us to say these are real concerns,” Warner said. “These policies and changes are detrimental to not just our local hospital, but our local communities.”</p>
<hr>
</div>
<div class="field field–name-field-top-level-terms field–type-entity-reference field–label-hidden field__items">
<div class="field__item"><a href="/health" hreflang="en">Health</a></div>
</div>
<div class="field field–name-field-recurring-segments field–type-entity-reference field–label-hidden field__items">
<div class="field__item"><a href="/recurring-segments/investigations" hreflang="en">Investigations</a></div>
</div>
Media Feeds All
August 6, 2025 at 05:08AM
Illinois Delivered 