Cook County Health Provides Updates on Medicaid Eligibility and Infectious Diseases

Cook County Board Health and Hospital Committee Meeting
April 14, 2026 (regular meeting)

Cook County Health (CCH) CEO Erik Mikaitis, along with Kathy Chan and Alexandra Normington, presented  a report on CCH’s Medicaid Impact Workgroup (item # 23-0202).

• CCH is asking everyone to share the Medicaid Facts Microsite:  https://getmedicaidfacts.com 
• Medicaid Eligibility Changes as a result of the bill known as H.R.1 passed in 2025 include: (1) Narrows definition of “qualified immigrant” which will end eligibility for many lawfully present individuals (such as refugee and asylum seekers and victims of domestic violence and trafficking) – effective October 1, 2026; (2) Redeterminations for Affordable Care Act (ACA) adults - twice a year (instead of annual)– effective January 1, 2027; (3) New Federal Medicaid Rules require 80 hours per month of work, school, or volunteering effective January 1, 2027. Federal guidance with more specifics expected June 2026. 
• As a result of these changes, 400,000 people in Illinois are estimated to lose coverage, including 20,000 CCH patients. This could result in a $280 M negative impact on CCH’s budget.
• Up to now, even though County Care has one of the highest retention rates for Medicaid managed care plans, between 11 and 14% lose coverage during every redetermination period:  70% due to paperwork/administration issues; 30% due to no longer being eligible.
• Arkansas implemented work requirements in 2018:  18,000 enrollees lost coverage; 97% of those were eligible; and the State spent $26 M to implement before the program was halted by a federal judge after 4 months.
• Provided Update on the Cook County Health Medicaid Impact Workgroup. In September 2025, Cook County Health hosted a cross-sector convening of 60+ health care providers, payers, foundations, academia, advocates, community organizations, business to mitigate harms from H.R.1 eligibility changes. 
• Three sub-groups have been established: Communicate & Educate, Coalition Building, Innovate & Create. CCH is also working with the National Association of Counties (NACo) to scale best practices, learn from other counties, and leverage collective advocacy opportunities 
• Cook County Health created a communications toolkit in 6 languages that provides resources for partners to share. Materials were purposefully left unbranded to allow other orgs to brand, supporting increased use, visibility and trust. 
• Commissioners Lowry and Anaya spoke of the need to elevate the conversation at the state level and the need for a toolkit for Commissioners who will be lobbying state officials. They emphasized the need for coordinated state messaging. Commissioner Lowry will ask for an update from the County’s legislative lobbying team. 
• Commissioners Miller and McCaskill questioned which members (community and academic) from the suburban community were invited to participate in the CCH Medicaid Impact Workgroup. Kathy Chan responded that currently there is no academic representation and one or two community representatives. CCH leadership agreed to work with Commissioners to increase participation from the suburban community. 
• Commissioners Daley and Stamps asked that the newly created communications toolkit be sent to the Commissioners so it can be tied to their outreach events. Both Commissioners emphasized the need for tighter communication between commissioners and the County’s legislative lobbying team.
• In response to questions from Commissioner Daley regarding the Health System impact of the closing of West Suburban Hospital, Dr. Mikaitis said the Health System received 65 to 70 transfers. Dr. Mikaitis announced that Craig Williams, Executive Chief Operating Officer, will be leaving the Health System for a new position.

Dr. Kiran Joshi, head of the Cook County Department of Public Health (CCDPH) provided the quarterly update on COVID-19 and Infectious Diseases (Item 22-3815):

• A judicial order issued in March temporarily blocks changes to federal immunization recommendations. The halts are temporary, pending either a trial or a decision for summary judgment.
• Despite judicial ruling, the U.S. Dept of Health & Human Services published a revised charter for ACIP (Advisory Committee on Immunization Practices) on April 9 which puts greater emphasis on potential harms from vaccines and allows for membership on the Committee beyond past emphasis on expertise in immunization practice.
• COVID-19 vaccination is still recommended and older adults/those at high risk could consider a booster
• Flu and RSV remain low; COVID-19 remains minimal as of 4/4/26
• 2025-26 Free Flu & Covid Vaccination Clinics: Eight events with community organizations plus 22 with the Access Community Health Network held:  1897 vaccines administered. CCDPH is working to move the vaccinations clinics to larger and public spaces for 2027  
• Commissioner Trevor asked about the weight of recommendations for immunizations from professional organizations and the impact on reimbursement from insurance companies. Dr Joshi answered hat the national association of insurance companies has issued a statement that it supports science-based recommendations which in effect indicate support of the professional recommendations. 

Observer: Susan Avila