State and Cook County medical debt relief efforts have eliminated more than $2.4 billion in medical debt for approximately 1.5 million Illinois residents, according to an October 15 announcement by Governor JB Pritzker and Cook County Board President Toni Preckwinkle. The combined initiatives have reached residents in all 102 Illinois counties, demonstrating how a county-led initiative can provide a model for statewide action.
Speaking at Cook County Health, officials highlighted the programs’ impact on household finances and access to care. Medical debt can force residents to delay treatment, leave prescriptions unfilled or choose between paying medical bills and meeting basic needs.
County Leadership Established the Model
Cook County became the first local government in the nation to use American Rescue Plan Act (ARPA) funds to eliminate residents’ medical debt, according to county officials. Working with the nonprofit Undue Medical Debt, the county purchases qualifying debt at a substantial discount and cancels it.
Preckwinkle reported that Cook County’s program alone has eliminated more than $1 billion in medical debt for nearly 800,000 residents—approximately one in five adults in the county. Roughly $9 million in federal funds supported that relief.
The county’s approach helped inspire the Illinois Medical Debt Relief Program. Pritzker credited Cook County’s leadership with demonstrating that the model could be expanded to assist residents throughout Illinois.
Relief Reaches Communities Across Illinois
According to figures presented at the announcement, the combined state and county efforts have canceled an average of nearly $1,600 in debt per recipient. In 40 Illinois counties, more than 5 percent of residents have benefited. In Kankakee County, the share was nearly 22 percent.
Officials reported that each dollar spent through the initiative has eliminated approximately $100 in medical debt. That purchasing power reflects the discounted price at which outstanding debt can be acquired; the amount of debt canceled substantially exceeds the public dollars spent.
Recipients do not apply for assistance. Instead, qualifying debt is identified through records obtained through the debt acquisition process, and affected residents receive letters notifying them that the identified debt has been canceled. Preckwinkle said Cook County recipients face no application paperwork or tax consequences from the relief.
Cook County Plans Continued Funding
With ARPA funding winding down, Preckwinkle announced that Cook County will continue supporting medical debt relief with county dollars in 2027. She also said the county intends to use information gathered through the initiative to better understand who incurs medical debt, why it occurs and what policies could address its underlying causes.
Pritzker expressed support for continuing the statewide effort while acknowledging that future funding will require difficult budget decisions. His remarks did not identify a specific long-term funding commitment.
Relevance for Counties
The initiative illustrates the role counties can play in addressing the connection between residents’ financial stability and public health. Speakers emphasized that the fear of unaffordable bills can discourage patients from seeking timely care, potentially allowing health conditions to worsen.
For county officials, Cook County’s experience also offers an example of how local innovation and partnerships with nonprofit organizations can inform broader state policy. As the programs move forward, sustained funding and efforts to prevent new medical debt will remain central to the discussion.