On Tuesday, February 13, HC3 hosted its first summit of 2025, bringing together leaders and experts to discuss the future of Chicago’s medical safety net. In collaboration with HC3’s parent organization, Third Horizon, the event provided a platform to address the existential threats facing Medicaid, safety net hospitals, and the broader health care ecosystem. The summit featured powerful remarks from Illinois State Representative Lindsay LaPointe, an urgent keynote from David Smith, and an engaging panel discussion featuring key voices from health care and policy.
Beyond a "Call To Action" - Digital Copy
Chicago's safety net hospitals face a $2.46 billion loss from 2025 to 2030, threatening access to essential care for underserved communities. Addressing this crisis requires urgent, collective action from policymakers, health systems, businesses, and philanthropists to create a more efficient, well-funded, and integrated health care system. A digital copy of the 1-pager distributed at the summit is available here.
Watch the Event:
HC3 Podcast: Season 3, Ep 1: Re-assessing the Challenging Future of Chicago’s Medical Safety Net Take the event with you! The HC3 Podcast is available for download and streaming on all major podcast platforms.
EVENT RECAP
Illinois Legislator Remarks
Illinois State Representative Lindsay LaPointe (D-19th District) set the stage for the discussion with a sobering assessment of the challenges facing Illinois' health care system. As the chair of the Mental Health and Addiction Committee and a member of the Medicaid Working Group, she brought a deep understanding of how Medicaid underpins behavioral health services, long-term care, and key social determinants of health. Speaking to a room filled with health care leaders, policymakers, and advocates, LaPointe underscored the critical role Medicaid plays in ensuring access to care for the state’s most vulnerable populations.
"Medicaid is the biggest funder of behavioral health, AIDS care, and long-term care in Illinois,"Â she stated firmly. "We cannot talk about health care access or social determinants without talking about Medicaid."
Beyond its essential role in funding services, Medicaid also represents a significant financial commitment from the federal government. LaPointe highlighted the staggering $7.34 billion in federal funds Illinois receives annually for Medicaid expansion, warning of the dire consequences if the federal match were to dip below 90%.
"If the federal match drops below 90%, Illinois is on a 90-day runway,"Â she cautioned. "Without action, we lose Medicaid expansion, and 772,000 people could lose health care."
LaPointe stressed the high stakes—losing coverage for hundreds of thousands would strain hospitals, emergency rooms, and community health centers already at capacity. Her call to action was clear: Illinois must act now to protect Medicaid and preserve its health care safety net.
Keynote Address: Navigating the Challenging Future of Chicago’s Medical Safety Net
David Smith, co-founder of HC3 and Founder and CEO of Third Horizon, made his keynote address with a sobering analysis of the crisis facing Chicago’s medical safety net. He painted a stark picture of the challenges ahead—financial instability, workforce shortages, and reimbursement models that simply do not support the level of care needed in vulnerable communities. He shared projections that underscored the urgency of the moment, revealing a staggering $2.46 billion funding gap over the next five years for Chicago’s safety net hospitals.
David also outlined a vision for restructuring the safety net—one that included strategic consolidation, recapitalization, and a collaborative approach involving state leadership, managed care organizations, hospitals, and philanthropy. "If something transformative doesn’t happen in the next 18 months, we will see three to five hospitals fail," he cautioned. We are beyond a call to action. The current operating model is unsustainable and will fail within months, not years."
David concluded that the path forward requires difficult decisions, new partnerships, and a willingness to reimagine how safety-net hospitals operate.
Panel Discussion: Building Resilience and Driving Change for Chicago's Medical Safety Net
Moderated by David Smith, the panel featured key health care and social service leaders discussing innovative solutions to ensure the viability of Chicago’s safety net ecosystem.
Featured Panelists:
Dr. James Brooks, President & CEO, Lawndale Christian Health Center
Rushil Desai, President & CEO, Aetna Better Health of Illinois, a CVS Company
Brenda Battle, Executive Consultant, UChicago Medicine
Mark Ishaug, CEO, Thresholds
This panel of leaders underscored the urgent need to invest in staff well-being in provider settings. As workforce shortages persist and funding uncertainties loom, leaders shared their concerns about sustaining essential services for Chicago’s most vulnerable communities.
Dr. James Brooks of Lawndale Christian Health Center voiced a shared concern—potential Medicaid cuts threaten his 750-member staff, including vital non-clinical workers. "I worry about our staff," he said. "If Medicaid gets cut, what will it look like, especially for our non-clinical staff?"
Panelists examined financial sustainability, with Rushil Desai of Aetna Better Health of Illinois advocating for value-based care to improve outcomes and efficiency. "Keeping members out of the ER and ensuring access to primary care is essential for lowering costs and improving outcomes,"Â he said, emphasizing the role of preventative and community-based care.
The growing wave of hospital closures threatens Chicago’s safety net. Brenda Battle, executive consultant at UChicago Medicine, warned of worsening emergency room overcrowding. "Emergency department utilization is already at record highs," she said. "If we lose more hospitals, people will wait 18 to 20 hours to be seen." As hospitals close, remaining facilities will face even greater strain, leaving patients with limited options for care.
Mark Ishaug, CEO of Thresholds, brought yet another critical piece of the puzzle into focus—the intersection of health care and housing. Without stable housing, he argued, any effort to improve health outcomes would be incomplete. "Home, health, and hope must go hand in hand," he said. "We cannot address health care access without also addressing housing instability."
Looking Ahead
The HC3 Summit made one message clear: without immediate, systemic reforms, Chicago’s health care safety net is at risk of collapse. Policymakers, providers, payers, and community leaders must come together to forge a sustainable path forward. The coming months will be pivotal in determining the future of health care access for Chicago’s most vulnerable populations.
HC3 remains committed to keeping these conversations at the forefront and advocating for meaningful change. Stay connected for continued discussions and updates on this critical issue.
