Prepared Remarks

Dr. Jay Shannon, CEO

Cook County Health & Hospitals System
February 21, 2017

Testimony of Dr. Jay Shannon, CEO Cook County Health & Hospitals System

Good morning. I am Dr. John Jay Shannon, CEO of the Cook County Health &
Hospitals System. Thank you to SEIU Healthcare and Dian Palmer for your ongoing
advocacy about the importance of the ACA and what it has meant to the patients
we serve.

Thank you to President Preckwinkle and the members of the County board who
have joined us today. Your continued support of the health system is greatly
appreciated.

CCHHS is one of the largest public health systems in the nation and serves as the
safety net for health care in Chicago and suburban Cook County.

In 2015, CCHHS provided in excess of $500M in uncompensated care, including

45% of all the charity care provided by hospitals in Cook County.

CCHHS is more than Cook County Hospital. It is comprised of two Joint

Commission-accredited hospitals, more than a dozen community health centers,
the Ruth M. Rothstein Core Center, a primary care center for patients with HIV and
other infectious diseases, the Community Triage Center, located in the Roseland
community, which is a stabilization center for patients in need of behavioral
health services, the Cook County Department of Public Health, Cermak Health
Services, which provides primary and specialty care to individuals at the Cook
County Jail and the Juvenile Temporary Detention Center, and CountyCare, a
Medicaid managed health plan.

CCHHS cares for more than 300,000 patients each year and our physicians are
experts in their fields, committed to providing our patients with comprehensive,
compassionate and cutting-edge care.

CCHHS flagship 450-bed John H. Stroger Jr. Hospital provides nationally-certified

stroke, oncology and burn care and has centers of excellence in emergency
medicine, infectious disease, endocrinology and others. The nations first
comprehensive trauma unit opened at Cook County Hospital in 1966.

Our history and mission to care for all dates back to 1835. In that time, we have
cared for millions of individuals, trained thousands of doctors and supported
important research that has contributed to modern day best practices in hospitals
throughout the country and the world.

Today, CCHHS is transforming the provision of health care in Cook County by

promoting community-based primary and preventive care, developing a robust,
collaborative health plan and enhancing the patient experience.

The ACA has been integral to CCHHS in that transformation.

Prior to the ACA, more than 1/2 of CCHHS patients were uninsured. Today CCHHS
now cares for a majority insured population.

This significant increase in insured individuals, largely driven by Medicaid

expansion, has allowed CCHHS to be reimbursed for services provided to patients,
many of whom sought care at CCHHS when they were uninsured.

In fact, CCHHS has been able to withstand a 75% decrease in local tax support to
fund CCHHS operations since 2009, from $481 million to $111.5 million in 2017, in
large part due to the new revenues available as a result of implementation of the
ACA.

Thanks to health care reform, and continued operational efficiencies, for the first
time in our history CCHHS has broken even for the past three years. This fiscal
independence and sustainability is largely dependent on the preservation of the
ACA.

Todays dynamic and changing healthcare landscape is of great concern to

CCHHS. The potential for repeal of the ACA, particularly without a replacement
plan would be devastating to the constituents you represent, the community-
based health care providers in your districts and wards and the patients we care
for. We also estimate that it would increase the amount of uncompensated care
we provide by at least $100 million dollars.

Repeal could cause more than 483,000 Cook County residents to lose their health
insurance.
Of the 140,000+ members enrolled in CountyCare, 40% are ACA adults and would
not be eligible for coverage if Medicaid expansion is repealed.

Those who lose their insurance may have no other options for alternate insurance
coverage. They may be forced to discontinue pharmaceutical therapies for chronic
diseases such as diabetes, heart disease. They will likely go back to relying on
local emergency departments for basic health needs or waiting until they are
acutely ill to seek care a much more costly way to receive care and, more
importantly, not in the best interest of patients.

For 180 years, the Cook County Health & Hospitals System has served as a health
care safety net. With repeal of the ACA looming we will continue to focus first and
foremost on the needs of our patients who seek our help. We will continue to be
flexible and do as much as we can and, for as many as we can. We will continue
to care for anyone who comes through our doors.

But in the end, should the ACA be repealed, it is the patient who will be most
impacted. Their ability to access preventive care to manage their diabetes and
heart disease would be seriously compromised. They will go back to the days of
choosing food for their families or the medications to stabilize their health.

These are not choices that any human being should have to make no less a
human being living in the richest nation in the world.

Thank you.