Trump’s Budget Bill Strips Healthcare from 330,000 Illinoisans, Increases Costs for Working Families
Premiums on ACA Expected to Rise by 75% for Working Families
July 8, 2025
CHICAGO — Following the signing of Trump and Congressional Republicans’ budget bill, Illinois is raising awareness about the devastating impact on working families’ access to healthcare. With the stroke of a pen, Trump has signed into law the largest cut to Medicaid in American history that will strip coverage from an estimated 330,000 Illinoisans, burden working families with increased premiums, deductibles, and out-of-pocket healthcare costs, and threaten hospitals and nursing homes across the state, especially in rural areas.
Vulnerable populations, including children, seniors, people with disabilities, and low-income families, will lose coverage under administratively burdensome eligibility policies. Among the hardest hit will be the 64 percent of nondisabled adults who are working and must now also navigate new work requirements to retain their coverage.
“Donald Trump sold out the American people, stripping away their healthcare and raising costs for working families in order to line the pockets of his wealthy friends,” said Governor JB Pritzker. “The widespread health and economic impacts of the largest cut to Medicaid in American history will be devastating for years to come. It will cost people their livelihoods, strain working families, shutter hospitals, and slash reproductive healthcare. In Illinois, we will never waver in our commitment to fighting for our people and doing everything in our power to mitigate the impact of this devastating bill.”
"I have personally navigated the ins and outs of American healthcare — as both a caretaker and someone who needed care. I do not take cuts to healthcare lightly because I cannot see those numbers without seeing the real faces behind them,” said Lieutenant Governor Juliana Stratton. “The future President Trump and Congressional Republicans have forced on our state will come with needless suffering; this moment calls for us all to stand up, speak out, and fight back together. Governor Pritzker and I will do everything in our power to soften the blow on Illinois’ communities."
“The federal Medicaid cuts will be devastating, as they will strip coverage away from many of our current customers, strain providers across the state, diminish funding for critical reproductive healthcare services, and bring major fiscal pressures for the state,” said HFS Director Elizabeth M. Whitehorn. “HFS will do everything we can to minimize the harm of these cuts for Illinoisans.”
Medicaid also plays a pivotal role in the economy of every state, including Illinois. In Illinois, hospitals and health systems support approximately 445,000 full time jobs while generating $117.7 billion for the state annually. Many hospitals – especially in rural areas – rely on Medicaid payments to maintain operations, including to maintain access to emergency room care.
From rural hospitals to nursing homes, no corner of the state will be spared. Key impacts include:
- Medicaid Coverage Loss for 330,000 Illinoisans: According to Manatt Health, about 11% of current Medicaid enrollees in Illinois will lose coverage over the next decade.
- Illinois currently has 3.4 million Medicaid enrollees:
- 44% are children
- 9% are seniors
- 7% are adults with disabilities
- Illinois currently has 3.4 million Medicaid enrollees:
- Out of Pocket Expenses Expected to Rise for Medicaid Enrollees: ACA expansion adults - childless, nondisabled adults ages 19 through 64 enrolled in Medicaid - with incomes over 100% of the federal poverty level will be subject to cost-sharing for most healthcare services. For instance, an Illinois couple earning just over $21,000 per year could be subject to over $1,000 in higher out-of-pocket medical costs each year.
- Premiums will Increase 75% for Working Families with ACA Marketplace Coverage: Illinois families with ACA plans will pay an average of $1,032 more per year in premiums. Rural Illinoisans will be even harder hit, with an estimated increase of $1,700. Even those not on ACA Marketplace plans like employers and privately insured individuals will face rising costs and fewer provider options due to market instability and growing uncompensated care burdens on hospitals.
- Rural Hospitals and Nursing Homes in Jeopardy: 9 rural hospitals and over 90 nursing homes could face closure in Illinois, leaving entire communities and counties without access to care and an economic engine.
- Over $50 Billion in Medicaid Funding at Risk for 3.4 Million Illinoisans: Manatt Health estimates that the bill would force Illinois to lose about $52 billion in Medicaid funds over 10 years and put the coverage and benefits for all 3.4 million Illinoisans on Medicaid at risk. Freezing current provider taxes, reducing the hold harmless threshold for provider taxes in expansion states, and restricting state directed payments would be detrimental to not only the state budget but the hospitals, health systems, and approximately 240,000 providers who rely on payments from HFS for the care they provide to Illinois Medicaid customers.
- New Barriers to Coverage Through Work Requirements, Frequent Redeterminations, and Repealing Rules that Simplify Eligibility and Renewal: the bill imposes frequent and administratively burdensome eligibility checks and new work requirements. Illinois would face millions in IT costs and need to hire hundreds of new staff members to implement burdensome systems, draining state resources and harming access for eligible enrollees. Additionally, by changing enrollment rules, including implementing short enrollment periods and additional onerous requirements, Illinois’ most vulnerable eligible families will face an uphill battle to successfully navigate the system’s new red tape and enroll in benefits they are owed. Ultimately, these barriers will push more people to be uninsured, shift costs to hospitals and other providers, and lose the progress made under the ACA.
- Gutting of Reproductive Healthcare: Effective immediately, the bill also prohibits federal Medicaid matching funds for family planning and other reproductive healthcare services provided to Medicaid customers by Planned Parenthood clinics across the state.
Alongside gutting healthcare for millions, this bill will slash funding for SNAP for working families, cuts funding for education all while increasing energy costs for families and more. While Illinois has repeatedly made clear that the state is not in a position to backfill funding for cuts to Medicaid, Gov. Pritzker remains committed to mitigating the impact to the greatest extent possible and continuing to prioritize key healthcare initiatives, such as the medical debt relief program, the birth equity initiative and implement new laws that will lower prescription costs and expand healthcare access.
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