For close to 200 years, the Cook County Health system has provided care for any patient who comes through the door. During the past decade, the Affordable Care Act, also known as Obamacare, helped ease the patient load. But, that will change when ACA subsidies expire at midnight.
"We're very concerned. I'm an emergency room physician by training. And I will say, in one of my most recent shifts, I've actually had two patients that had delayed presentations due to lack of insurance," Cook County Health Chief Medical Officer Dr. Lauren Smith said.
Without an extension of ACA subsidies, premiums are expected to double and triple for the 550,000 Illinoisans enrolled in the marketplace, making it unaffordable for many.
"We know that when people lose coverage, they often delay care until conditions worsen, and emergency rooms become their only optional," Cook County Board President Toni Preckwinkle said.
If people lose their insurance, Cook County Health is estimating it will cost an extra $100 million for charity care next year.
Smith expects hospital backlogs as people who need medications or routine care will come to the emergency room rather than their primary care doctor.
"Anyone else showing up in the ER may have to wait longer. Hospital stays become longer because you're creating presenting in a much more critical condition. So you may need the ICU now, as opposed to a regular medical/surgical unit," Smith said.
Dr. Smith says she plans to create efficiencies within the hospital to handle the extra load.
Illinois Congressman Raja Krishnamoorthi says action extending the subsidies may happen next week in Congress.
"It's set for a vote next week, and it's likely to pass because I think at least four Republicans signed that discharge petition. And joining with all Democrats, there will be enough votes to take it through the House," said Krishnamoorthi, a Democrat representing the 8th District.
Even if the House passes an ACA tax credit extension, it is then up to the Senate to act. And so far, the Republican-led Senate has yet to present a plan.