There was a lot of talk but no action in Washington this week. It increasingly looks like Congress will allow the expiration of the premium tax credits that have sent prices for insurance plans on the Obamacare exchanges soaring. Millions of people are expected to drop health insurance coverage simply because they can’t afford the upfront premiums for policies whose out-of-pocket costs on average will rise by more than 70%.
Even if our elected officials do something, it’s not going to solve an even larger crisis that will emerge during 2026: The massive cuts to the Medicaid program, a few of which are already happening but will mostly go into effect for 2027 — just after the midterm elections.
For this week’s podcast, I invited on a healthcare leader who will be on the front lines of dealing with the Medicaid crisis. Dr. Erik Mikaitis is the Chief Executive Officer of Cook County Health, which runs the largest safety net hospital in the second largest county in the country (which also happens to be the city where I live).
Cook County Health gets fully 56% of its $2 billion in annual revenue from Medicaid. It also runs a $3 billion-a-year health plan — County Care — that covers over 400,000 low income residents on Medicaid. Dr. Mikaitis is a board certified internal medicine physician who joined Cook County Health as its chief quality Officer in 2022. He’s been running the organization since November of 2023.
Listening to this podcast is worth a half hour of your time. He reveals how safety net hospitals like those in Cook County are organizing to fight the $1 trillion in cuts to Medicaid — the largest cutback in the program’s history — that were contained in Donald Trump’s One Big Ugly Bill.
