On the first day of the new Congress, Republicans introduced a budget resolution aimed at making good on their threat to repeal the Affordable Care Act. In spite of the chaos this will cause in the health insurance market, Republicans have yet to introduce any replacement program for the millions of Americans who now have health insurance coverage through the ACA.


Equally devastating, Republican leadership has proposed to deeply cut federal support for Medicaid through block grants or “per capita caps” which shift billions in cost for health care to our state. The human and economic cost of repeal would hit Illinois hard. I have come to know, and feel compelled to share the story of one, of literally countless others, whose life would be dismantled by the repeal of the Affordable Care Act.

Life became challenging in 2009 for “Aaron,” who lives in Aurora. He lost his job and with it, his health insurance. Aaron suffers from heart and other health conditions that require 10 daily medications. After losing his insurance, he struggled to get his medications and could not afford to regularly see a doctor, so he waited until he was sick enough to be seen at an emergency room.

Aaron visited countless ERs, had two heart attacks and needed three cardiac surgeries while he was uninsured. He also became homeless.

Things changed in 2014. Aaron, along with 11 million adults and 645,000 Illinoisans, obtained health insurance through the Affordable Care Act’s Medicaid expansion. Prior to the ACA, Medicaid eligibility for adults like Aaron was extremely limited. Adults who did not have children, no matter how poor they were, generally were not eligible. Since obtaining coverage under Medicaid expansion, Aaron regularly sees his doctors and gets treatment before his condition is an emergency. He has required no surgeries and has been to the emergency room much less often. Aaron moved out of a homeless shelter and he regularly volunteers in the community.

Aaron is one of the approximately 73 million Americans receiving the life-saving coverage Medicaid provides. Medicaid is the principal source of long-term care coverage for Americans.

One in five children in the United States is covered by Medicaid. Seniors and persons with disabilities make up one-quarter of those in the program. Aaron and the millions of others like him are the human face of Medicaid. Repealing the ACA or capping federal funding for Medicaid will return Aaron to the world of 2009 where lack of access to health care is life- threatening.

The economic costs of repeal are also staggering. Under repeal, Illinois will lose $3.1 billion of federal funding made available for the Medicaid expansion. Our communities will also lose significant federal funding for hospitals, community health centers, physicians, and nursing homes as well as the economic growth and stability that came with that funding. The Illinois Hospital Association estimates that repeal alone could cost Illinois more than 84,000 jobs. Block grant and cap proposals cut federal funding for Medicaid by as much as one third, stripping billions of dollars from Illinois at a time of extraordinary state fiscal woes.

Aaron has made drastic improvements personally since 2014, and the coverage he has received has proven financially beneficial to the state in fewer emergency room visits and remaining housed. Illinois has seen real economic benefit from the return of billions more of our federal tax dollars to our state.

Returning to 2009 is a moral and economic disaster. For Aaron’s sake, and for millions like him, we must let Congress know that it is a mistake Illinois simply cannot afford.

Colleen Boraca is a clinical assistant professor at Northern Illinois University College of Law. She directs the Northern Illinois University College of Law Health Advocacy Clinic in Aurora.

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