A Checkup for Cook Coun ty's Safety Net: - A Qualitative Review of Health Reform

Research Findings Strengths and Assets When asked to characterize the safety net overall, the individuals who Health & Medicine spoke with noted challenges, but also highlighted the distinct strengths of the Cook County safety net, especially the dedication of staff members and the rich array of collaborative organizations that share a mission to provide healthcare to all who need it. [...] In 2016, Health & Medicine Policy Research Group and Loyola University Stritch School of Medicine published research assessing the state of the Cook County safety net and recommending strategies to protect and build its capacity to adapt to the reforms, counter- reforms, and continued uncertainty of the ACA era. [...] Several national shocks to the ACA Marketplaces from the Trump administration— including the elimination of the individual mandate requiring minimum insurance coverage of most Americans, cuts to enrollment assistance and Marketplace cost-sharing reduction programs, and the refusal to defend the ACA in lawsuits challenging the legitimacy of the law’s pre-existing condition protections—led to a decl. [...] The law introduces reforms to eligibility determination and redetermination to stabilize the current system and improve the process to avoid future backlogs: ○ The Omnibus also required a review of the entire redetermination process to end the “revolving door” of eligible individuals losing coverage during the redetermination process ○ The law specifically calls for the expansion to new categories. [...] A holistic view of the healthcare safety net must consider the health impact of these kinds of employment changes and ways to mitigate the harms of job loss without constraining the ability of hospitals to effectively meet community health needs.