Featured FAN: Kathy Chan

A CONVERSATION WITH KATHY CHAN

Each quarter, we feature a Federal Action Network (FAN) member leading the charge on Capitol Hill to protect essential hospitals.

This quarter, we spoke with Kathy Chan, director of policy at Cook County Health, about guiding patients through Medicaid coverage shifts, pressing policy issues, and the next generation of health care leaders.

After nearly 13 years with Cook County Health, what has consistently inspired you in your role as director of policy? What is something new you've grown to appreciate or learn over time?

I'm so fortunate to be able to work at a place where the mission and work of the organization align with my personal values when it comes to equity and social justice. Everyone from front-line staff, providers, and administration work together to provide all of our patients with high-quality care and access to health services, regardless of their ability to pay or background. As someone who has worked to change systems and policies for the better, being where I am at Cook County Health presents the opportunity to model these changes in-house while also pushing for them elsewhere.

It's also extremely meaningful to be working for health care and government, especially in a time when public trust in both has eroded particularly at the national level. I've recently been leaning into the "public hospital" description of my job to let people know how government is working to help make their lives and the lives of their neighbors and communities better.

What are the most pressing policy challenges facing essential hospitals today, and how is Cook County Health working to solve them?

H.R. 1 and its impact on Medicaid are top of mind for Cook County Health. An estimated 400,000 Illinois residents, or more than 1 in every 10 people, are at risk of losing Medicaid by 2028 as a result of Medicaid eligibility changes, including the twice-a-year redetermination and new work requirements. Cook County Health estimates that 20,000 of our patients will lose Medicaid coverage, with some unable to get it back.

Given that the majority of Cook County Health patients who have insurance are covered by Medicaid and that more than 390,000 Cook County residents are covered by CountyCare, Cook County Health's Medicaid managed care plan, it made sense for us to take a leadership role to mitigate harms from H.R. 1.

Last September, Cook County Health kicked off the first meeting of the Medicaid Impact Workgroup, a cross-sector convening of stakeholders from health care, managed care, foundations, state and local government, academia, community organizations, business, and technology to identify short- and long-term action items to preserve Medicaid for those who remain eligible and address the health needs of those who will not long have access to health insurance coverage. In addition to the large group meetings, three sub-groups have also formed: communicate/educate, coalition building, and innovate/create. The innovate/create group is doing work at the request of state Medicaid to identify opportunities to better optimize and leverage existing technology platforms and data transfer systems for Medicaid providers and enrollees, given the short window of time to operationalize federal guidance.

Earlier this month, Cook County Health launched Get Medicaid Facts, a new microsite and communications toolkit designed to help Medicaid enrollees and community partners prepare for significant upcoming changes to Medicaid eligibility. The communication resources were identified at the initial Medicaid Impact Workgroup meeting as a need to help combat misinformation. While Cook County Health created the microsite and toolkit, the downloadable materials are intentionally unbranded to allow for partner organizations to add their name and logo and distribute as the trusted partner to their communities and constituencies. We have received a great deal of positive feedback about the site and contents, including from a provider outside of Illinois interested in replicating this work, and will update the microsite once further guidance about work requirements is available.

Cook County serves a varied population, including many immigrant communities. How does Cook County Health adapt to ensure high-quality care for all who come through its doors?

Cook County Health has a long and storied history of providing care to all, regardless of their background, ability to pay, or immigration status. While recent policy changes and actions have presented new challenges, we continue to emphasize that we welcome everyone who needs care to our hospitals and health centers.

In early 2025, Cook County Health revived communication materials that were originally developed in 2017 to reiterate to our patients and community partners that "All Are Welcome Here." We also created resources to ensure that staff were trained to appropriately respond to any law enforcement, including immigration or border patrol officers, that may present to our facilities. Leadership regularly rounded on this issue and "practiced" scenarios with our staff to ensure that protocols were followed. Several other hospitals and health systems requested copies of the training and resources from Cook County Health. We've also been broadly advertising and making available telehealth options for all patients when possible.

Additionally, when a state-funded health care program for immigrant adults was sunset last summer, Cook County Health put into place a process to streamline enrollment for patients and community members losing this coverage to easily transition into CareLink, our charity care/financial assistance program. Individuals who lost state-funded coverage were granted CareLink eligibility for 12 months following completion of a simplified application. We shared this process with patients and CountyCare members we knew would be losing coverage, and with community partners including immigrant rights organizations.

You've previously held key roles at the Illinois Maternal and Child Health Coalition and the Illinois Department of Healthcare and Family Services. How did those experiences shape your approach to policy and prepare you for your current leadership role?

I've only ever worked for government and nonprofits, and these experiences have been so valuable to my work at Cook County Health. At EverThrive Illinois (formerly known as the Illinois Maternal and Child Health Coalition), I learned the value and power of working in coalition and got to know the major health care and advocacy partners working on Medicaid and health care access in Illinois. I also learned a great deal about the legislative process in our state and how to run a successful advocacy campaign.

At the Illinois Department of Healthcare and Family Services (HFS), the state Medicaid agency, my main role was to help implement All Kids, which was the first universal health insurance program for kids in the nation, and a program advocated for a while at EverThrive Illinois. While my time at HFS was relatively brief, I learned so much about the inner workings of state government and gained a new appreciation of civil servants and the unique constraints they often face even when there is tremendous support for policy changes.

At both of these organizations, I also worked with amazingly talented, smart, and inspiring leaders who taught me about policy, lobbying, fundraising, and so many other skills that could only be learned on the job. I'm fortunate to have gained so many lessons, learnings, friends, and colleagues that I'm still able to draw on today.

How do you define effective grassroots advocacy, and what role does America's Essential Hospitals Federal Action Network play in strengthening the voice of hospitals that fill a safety net role?

My first job out of college was in Green Corps, an organizing training program where I first learned about advocacy and the power of people to change policy. Effective grassroots advocacy requires a broad-based coalition that works towards short-term as well as long-term wins.

The America's Essential Hospitals FAN brings together hospitals of all sizes, serving urban and rural areas in locations with different political leanings, but with the same goal of ensuring that essential hospitals continue to have resources to provide their communities with high-quality health care. Our hospitals exist to serve communities that often have been historically under-resourced and bear disproportionate rates of poverty and chronic disease. Yet, our hospitals are also often the same places that find creative solutions and seek out partnerships to address needs that traditionally fall outside of health care, like food as medicine or transportation programs, because we know that these interventions help our patients reach optimal health and improve quality of life.

What gives you optimism about the future of health care?

I think the generation currently entering/graduating from college is more motivated than ever to address the issue of universal health care. For the past decade, I've facilitated summer sessions for Northwestern University undergraduate students who want to learn more about health care and the safety net systems in Chicago. Many of these students are pre-med or considering a career in health care. The discussions with these students during the various sessions focused on Medicaid, care for the uninsured, and with providers and public health leaders make it clear that young people are paying attention to the major issues of our time and want to find a way to contribute to a solution.

What is something that you are looking forward to this spring or summer that is unrelated to work?

I started riding my bike more often several years ago, including to and from work. While I try to bike year-round, I ride more often once all of the snow and ice is melted for the season. At the end of a long day, just being able to concentrate on a single activity (which is getting home safely) and not having to look at a screen, is really freeing. Cook County Health also participates in the annual Bike to Work challenge each May/June, and I'm also looking forward to contributing mileage that helps our team retain our first-place spot for local government participation!