The new program implements a provision of the Affordable Care Act (ACA) that allows states to expand Medicaid programs to cover most low-income individuals. The federal Center for Medicare and Medicaid Services (CMS) granted Cook County permission to launch this program in October 2012. Previously, as many as 250,000 Cook County residents were excluded from Medicaid because they did not meet the program’s restrictive eligibility requirements, such as being totally disabled.
The federally-funded Ryan White Program provides HIV medical care, medications, and supportive services to low-income people with HIV. The program is a payer of last resort, meaning all other sources of payment must be accessed before Ryan White Program funds can be used to cover needed services for people with HIV/AIDS.
Hundreds of people with HIV might have to switch from their current health care provider to one that is in the CountyCare network. Federal requirements prevented Cook County from enrolling all Ryan White Program providers in CountyCare.
It is estimated that half of all Americans diagnosed with HIV do not receive regular medical care, making CountyCare an unprecedented opportunity to reverse this trend in Northeast Illinois. Unlike traditional Medicaid, which requires single, low-income adults to be disabled, CountyCare eligibility is based solely on lawful residency in Cook County and income level.