Rising premiums and expiring Affordable Care Act subsidies are pricing some people out of healthcare coverage. That comes as Illinois replaces healthcare.gov with Get Covered Illinois as the state's health insurance marketplace.

Cook County authorities said they're bracing for what they call a health care crisis.

Just hours before federal subsidies that help people pay for health insurance under the Affordable Care Act expire, Cook County's public safety-net hospital is issuing a warning about the impact on people who could be left unable to afford an individual health insurance plan.

"They will arrive in our emergency room in far more dire circumstances than they would have had they had the coverage and had they had access to care," said Stroger Hospital Chief Medical Officer Dr. Lauren Smith. "Every hospital will have to absorb the increased demand. It won't just be at Stroger. It will go to all of our neighboring hospitals."

Critics said the failure in Congress to extend the tax credits in 2026 will send health insurance costs skyrocketing for more than half a million people in Illinois.

Officials estimated about a 100,000 people in Illinois will be priced out completely, forced to go without health coverage. Stroger Hospital staff said that would send more patients to their emergency room for even the most basic care, mimicking the hospital's experience before the Affordable Care Act went into effect more than a decade ago.

"We were over 100,000. We did see a decline in the emergency room visits, and now we're starting to see an uptick again, and it's already reflected in the 2025. At the end of 2025, we started to see those increase, so we only anticipate that those numbers and volumes are going to continue to grow," Smith said.

At Stroger, hospital officials said they will have to look for efficiencies and emphasize outpatient services. While they will not be adding extra staff to handle the increased demand for health care, they could look to reposition some nursing staff, though physicians are not easily moved between specialties.

Some Republicans in Congress have refused to extend the ACA subsidies, saying they are concerned about fraud or misuse.

When it comes to the ACA tax credits, recent CBS News polling with YouGov shows the vast majority – 68% – of respondents favored continuing the tax credits.

Of those polled, only 20% said health care this year was easily affordable, with 36% calling it difficult to afford already, and 44% of people saying they could afford it, though not easily.

Cook County Board President Toni Preckwinkle said every patient who comes to Stroger for health care will be treated, regardless of insurance status or ability to pay.