Statement on the Repeal of the Individual Mandate

December 20, 2017

The passage of the Republican tax plan by Congress, and with it the repeal of the individual mandate, is a heavy blow to the significant progress we have made regarding health care coverage in our country since the passage of the Affordable Care Act.  

The ACA was designed with three key components: insurance reforms, enhanced coverage accessibility (in the form of Medicaid expansion and subsidies to purchase commercial insurance), and the individual mandate. Each component serves as a support or balance for the others, all with the goal of more Americans with health coverage, and better expectations for essential benefits from that coverage.

The individual mandate required every person to have health coverage, or to pay penalties that helped offset the expenses of expanded state and federal health coverage programs. This broadened the risk pools, ensuring that insurers had both healthy and less healthy individuals buying in to coverage- that’s how insurance is supposed to work. Without the individual mandate, health plan enrollees will be predominately sicker and older, burdening insurers with higher costs that in turn will result in higher premiums and deductibles, only further deterring otherwise healthy people from buying insurance before they need it.  Before the ACA, a study published in the Journal of the American Medical Association found that 62% of all bankruptcies were medical related. Not coincidentally, from 2010 to 2016, the years post-ACA passage, bankruptcy filing fell by 50%. 

CCHHS proudly cares for insured and uninsured residents of Cook County. As a result of this action, we expect to see an increase in the number of uninsured patients coming to us with devastating conditions whose severity or stage is a consequence of an individual not seeking care earlier due to inadequate resources.  This will only further stress our region’s health care safety net.

Toni Preckwinkle

President, Cook County Board of Commissioners 

Dr. Jay Shannon

CEO, Cook County Health & Hospitals System