Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 1 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$264 million
$ 77 million
$820 million
5,900 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 67 million
$194 million
$736 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 2 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$280 million
$ 50 million
$795 million
5,700 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 67 million
$179 million
$707 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 3 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$151 million
$107 million
$624 million
4,500 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 57 million
$125 million
$555 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 4 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$204 million
$117 million
$773 million
5,600 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 33 million
$ 80 million
$348 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 5 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$128 million
$154 million
$679 million
4,900 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 67 million
$180 million
$717 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 6 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$ 68 million
$ 127 million
$ 471 million
3,400 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 57 million
$112 million
$561 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 7 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$296 million
$102 million
$959 million
6,900 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$181 million
$511 million
$1,968 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 8 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$111 million
$125 million
$568 million
4,100 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$32 million
$75 million
$331 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 9 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$155 million
$135 million
$700 million
5,000 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$125 million
$269 million
$1,222 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 10 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$ 94 million
$105 million
$481 million
3,500 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 32 million
$ 71 million
$321 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 11 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$113 million
$91 million
$491 million
3,500 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 65 million
$150 million
$650 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 12 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$201 million
$ 46 million
$594 million
4,300 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 55 million
$129 million
$559 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 13 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$163 million
$ 52 million
$518 million
3,700 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 85 million
$202 million
$871 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 14 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$ 70 million
$141 million
$510 million
3,700 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 22 million
$ 35 million
$188 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 15 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$146 million
$ 49 million
$470 million
3,400 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 29 million
$ 57 million
$268 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 16 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$124 million
$ 64 million
$453 million
3,300 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 33 million
$ 61 million
$304 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 17 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$198 million
$ 52 million
$601 million
4,300 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 95 million
$243 million
$996 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016

Preliminary Economic Impact of Affordable Care Act Repeal

If Congress repeals health coverage for over one million Illinoisans under the ACA and does not
replace it, preliminary estimates are that, statewide, Illinois would sustain a potential loss of
$11.6 billion to $13.1 billion in annual economic activity which translates to a potential loss of
84,000 to 95,000 jobs.
In addition, Illinois hospitals have already experienced over $1 billion in Medicare payment cuts
to help pay for ACA coverage. For 2016 2025, these hospital cuts will approximate another
$10 billion.
Position

Illinois hospitals strongly support ensuring continued access to healthcare coverage.

Any repeal of ACA coverage should not take effect until the replacement plan takes
effect.
If Congress does not make repeal of coverage contingent on adoption of a replacement
plan, then Congress should also repeal the hospital payment cuts that help pay for ACA
coverage.

Congressional District 18 Estimated Economic Impact

Lost spending for coverage of Medicaid ACA population:

Lost spending for coverage of Marketplace ACA population:
Lost economic impact with indirect ripple effect:
Potential job loss:

$121 million
$ 51 million
$414 million
3,000 jobs

Hospital Medicare payment cuts incurred 2010-2015:

Additional Hospital Medicare payment cuts 2016- 2020:
Total Hospital Medicare payment cuts 2010-2025:

$ 22 million
$ 39 million
$205 million

Sources:

Illinois Department of Healthcare and Family Services (HFS) Medicaid ACA Enrollment by congressional district, June 2016. Note:
HFS classified some enrollees as unknown so these enrollees are not included in any congressional district.
HFS CY2016 MCO Rate Certification for ACA population, July 2016.
U.S. Department of Health and Human Services (HHS) Assistant Secretary for Planning and Evaluation (ASPE) Plan Selections in
Health Insurance Marketplace, March 2016. Mapping by zip codes results in some zip codes allocated to multiple congressional
districts.
ASPE Office of Health Policy Research Brief, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace, October
2016.
IHA estimate of percentage of Marketplace beneficiaries who would obtain alternate coverage.
CMS payment rule Impact Files, Medicare Cost Reports (2012-2014) and Medicare Claims data (2014). All impacts reflect Medicare
FFS payments. Medicare impact analysis prepared by DataGen, subsidiary of Hospital Association of New York State, February 2016.

Economic Impact estimates based on Regional Input-Output Modeling System II (RIMS II), U.S. Bureau of Economic Analysis (BEA). The Final
Demand Multipliers, obtained from BEA RIMS-II, were applied to estimated cost of Medicaid and Marketplace coverage to obtain the total
economic impact (including ripple effect) of jobs and spending at risk throughout the state.

December 21, 2016