Illinois Healthcare on the Brink: Why We Must Fight the Federal Medicaid Cuts

The "Big Beautiful Bill," enacted by Congress and signed into law by President Donald Trump, includes devastating funding cuts to healthcare in Illinois. The unprecedented Medicaid cuts are not just a policy shift; they are a seismic event demanding immediate and coordinated action to manage their impact and reverse them.

For over four decades as a hospital administrator, I have navigated the turbulent waters of healthcare policy and led efforts to counter previous "doomsday proposals" coming from Washington DC. Each time, a united front of stakeholders, bolstered by broad public support, managed to halt drastic cuts. This time, however, the stakes feel higher, and the cuts are deeper.

The numbers paint a grim picture. One in four Illinoisans—3.2 million people—rely on Medicaid for their healthcare and peace of mind. Governor Pritzker's office estimates that 330,000 people will lose their benefits under this new federal law. Beyond the individual impact, these cuts could force the closure or cause severe service reductions at safety net hospitals across the state. The broader economic effect across these communities will be profound.

Early in my career I learned and never forgot the vital role of Medicaid as I sat with vulnerable AIDS patients and single mothers who shared with me their health struggles and reliance on Medicaid as a lifeline. Their fear, exhaustion, and need for help underscored the profound human impact of Medicaid. That same sense of responsibility to the most vulnerable must now galvanize us.

To avoid this looming crisis, we must act decisively on several fronts:

First, officials in Springfield and Washington D.C. must prioritize reversing the severity of these cuts. The delayed implementation of some of the worst provisions provides a window for more thoughtful action in the next few years. Governor Pritzker and the Illinois General Assembly were wise to set aside funds in the state’s FY 26 budget to address the coming cuts, but federal action is paramount.

Second, to my fellow healthcare leaders across Illinois, this is a moment for principled and compassionate leadership. Your dedicated workforce—doctors, nurses, technicians, and support staff—know the cuts are coming and are as anxious as the patients they care for. They need clear communication and a steadfast vision from

management that our institutions will weather this crisis and continue providing safe, effective, and compassionate care.

Finally, if you or a loved one depend on Medicaid, become an informed and vocal advocate. My experience has taught me that while data is important, the authentic, heartfelt stories of patients whose lives are transformed by Medicaid are what compel elected officials to act. Share your experience. Reach out to members of Congress.

Medicaid is far from perfect, and there is broad bipartisan support to better leverage 21st-century medical advances for our society's neediest. But draconian cuts alone will not achieve this. Only thoughtful, principled leadership, informed by the realities of providing healthcare to distressed communities, will lead to meaningful improvements. We cannot allow the "Big Beautiful Bill" to tear the fabric of the healthcare safety net for hundreds of thousands of Illinoisans.

• Susan Nordstrom Lopez served as President of Advocate Illinois Masonic Medical Center in the Chicago’s Lakeview neighborhood from 2003 to earlier this year. She is a Fellow of the American College of Health Care Executives.