Earl Williams Sr. finally has brought his diabetes under control. He's diligent about exercising, taking his medication and seeing his doctor.
"I had high sugar levels, I had high blood pressure, there was quite a few things that was going on with me that now I know how to control," said Williams.
Before the Affordable Care Act, hospitals had little incentive to reduce emergency department visits, especially from Medicare patients who generate a lot of revenue.
At University of Chicago Medicine, an academic medical center, Dr. Kenneth Polonsky said if those incentives are rescinded and patients forgo preventive care, they'll clog up already strained emergency rooms.
"We'll go back to a very frustrating time, where people had limited options for health care, because of inability to get health insurance," said Polonsky, dean of the Division of the Biological Sciences.
The uncertainty is also roiling county governments, which often fund medical care for the poor.
The burden on local taxpayers to fund the Cook County health system has dropped by $300 million since the health law went into effect, and repealing the law could force local governments to raise taxes.
"It's a $300 million hole in our budget," said Toni Preckwinkle, president of the Cook County Board of Commissioners. "There aren't a lot of options other than raising more revenue. It's a nightmare for us."
In Waukegan, Ill., near the Wisconsin border, Vista Health System chief executive Barbara Martin said that with more patients covered and additional reimbursement from the ACA, she has invested in new equipment and hired hundreds of new employees across Vista's two for-profit hospitals.
She said if the 900,000 Illinois residents who gained insurance under the law lose coverage — and hospital revenue drops suddenly — hospital executives estimate 95,000 jobs could be lost.
Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.