Cook County Launches Effort to Keep Residents on Medicaid as Thousands Face Losing Coverage

An estimated 400,000 individuals in Illinois could lose their health coverage due to federal Medicaid cuts that start in October 2026.

In 2025, federal lawmakers passed House Resolution (H.R.) 1, also known as the “One Big Beautiful Bill Act.” Key provisions of the legislation are projected to cut $1 trillion from Medicaid nationally over the next 10 years, including $26 billion in cuts to Medicaid funds for Illinois. An estimated 400,000 Illinoisans could lose coverage due to funding and eligibility changes contained in this legislation.

The act imposes new, stricter eligibility and work requirements. principally for those 19-64 years old. Here is the timeline the federal government has for rolling out the new regulations:

• This month: Federal guidance on exemptions/verification is expected.
• September 30, 2026: Deadline for states to inform enrollees about changes.
• October 1, 2026: Initial eligibility changes begin, including impacts on immigrant coverage.
• January 1, 2027: Broader compliance changes take effect.

To help enrollees, community organizations, health care providers, insurers, and public agencies prepare for these major changes to Medicaid eligibility, Cook County Health’s Medicaid Impact Workgroup has launched comprehensive online resources: Get Medicaid Facts which includes background information and frequently asked questions in English, Spanish and several other languages, and a communications toolkit, to help everyone spread the facts about these Medicaid changes via social media. These materials are available to all organizations who want to spread the word about upcoming changes and what steps enrollees can take to keep their coverage.

“Confusion about upcoming Medicaid changes is already leading people to lose coverage they are still eligible for, and that is a problem we can act on right now,” said Alexandra Normington, Chief Communications and Marketing Officer, Cook County Health. “Get Medicaid Facts resources are designed to give people clear, practical steps they can take right now, and to also equip community partners with consistent, accurate information. The more we can educate enrollees early and in a united way, the more people we can keep covered.”

In September 2025, Cook County Health convened the first meeting of the Medicaid Impact Workgroup, comprised of representatives from state and local agencies, health care and social service providers, insurers, businesses, academia and community organizations. The workgroup’s singular goal is to help eligible individuals in Cook County keep their Medicaid coverage despite federal cuts and policy changes.

“The healthcare provisions of H.R. 1 will bring widespread and complex shifts to the Medicaid program in the years to come, including more requirements customers must meet to be eligible for coverage and major financing changes that will put significant pressure on the state budget,” Illinois Department of Healthcare and Family Services Director Elizabeth M. Whitehorn said. “Mitigating the anticipated harm these federal changes will cause by helping customers navigate the new requirements to keep their coverage and working to ensure the Illinois Medicaid program can continue to cover as many critical healthcare services as possible are HFS’ top priorities. We are grateful to Cook County Health and to all of our partners who share these goals and commitment to Medicaid customers.”

The Cook County Health Medicaid Impact Workgroup includes representatives from Illinois Department of Healthcare and Family Services, Chicago Department of Public Health, CountyCare, Cook County Department of Public Health, Erie Family Health Centers, Greater Chicago Food Depository, Illinois Association of Free & Charitable Clinics, Illinois Chapter of the American Academy of Pediatrics, Illinois Hospital Association, NAMI Chicago, UI Health and more.