Chicago Primary Care offers a flat monthly membership for a primary care doctor at community health centers, posted cash prices for screenings and scans, and sign-up for Medicaid on the spot. You don't need insurance.
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PART OF THE NEW BURNHAM PLAN
CONSTRUCT · SYSTEMS
Chicago Primary Care
You can see a doctor without insurance.
For a flat monthly membership, you get a primary care doctor at a community health center, with no claim forms and no denial letters.
The gig worker with no employer plan, the hourly worker just over the Medicaid line, the family with a $4,000 deductible: all of them put off seeing a doctor until a small problem turns into a hospital stay. Meanwhile Cook County Health expects to provide about $485 million in free or discounted care in 2027.
I won't put tax money at risk running a city insurance company against claims nobody can predict. Chicago Primary Care makes care affordable without one. A flat monthly membership at community health centers the city contracts with covers a primary care doctor, physicals, chronic disease care, vaccines, basic labs and minor urgent care. Screenings and scans get posted cash prices, so you know what you'll pay before you walk in. And if you qualify for Medicaid, the clinic signs you up on the spot.
Every visit includes a mental health check-in, with a direct hand-off if you need more. It's built for anyone without a good plan: the self-employed, workers whose job doesn't offer coverage, and anyone who wants to know the price before the bill comes.
WHAT IT WON'T DO
It doesn't raise taxes or borrow money.
It doesn't replace good insurance. If you already have a low-deductible plan, your screenings are probably free already. Keep it.
It doesn't build a new city bureaucracy. It runs through the community health centers Chicago already has, and anything beyond primary care goes to Cook County's system, not a new city one.
It isn't insurance, but it doesn't leave you on your own if a screening finds something serious. You're referred to a specialist at a posted price or into CountyCare, Cook County's Medicaid plan.
How it connects
Nothing in this plan works alone. These are the questions people ask next, and the policies that answer them.
What if I need more than a check-in for my mental health? Mental Health & Addiction Recovery reopens mental health clinics on the South and West sides and keeps crisis care open around the clock.
Mental Health & Addiction Recovery →
Would I still need this if I earned a living wage? The Dignity Wage sets Chicago's minimum wage for adults at $30.53 an hour, 120% of what it costs one adult to live in Cook County.
Dignity Wage →
Where's the nearest clinic going to be? Each neighborhood is getting its own downtown, called a frunchroom, where the plan's new pipes, streets, energy and programs come together first.
Complete Neighborhoods: The Frunchroom →
FISCAL IMPACT
Investment Cost
RENOVATION STEP
Construct · Systems
SHOW THE FULL POLICY DETAILS
01
Where it ranks
OUR PRIORITIES
#31 of 33
SMALLER MOVE
30 / 100
Daily life
Long-term future
Reach
Unlocks
NEW It gives you a primary care doctor for a flat monthly membership, with no insurance required. It's a new design, so it's rated lower until it proves itself.
When you'd feel it: Year 2.
See all the priorities
How I set them
02
How it works
A membership, not insurance
You pay a flat monthly fee and get a primary care doctor: annual physicals, help managing conditions like diabetes and high blood pressure, vaccines, basic lab tests, prenatal and postnatal visits, minor urgent care and X-rays. There's no insurance card, no claim forms and no denial letters. It's set up as "direct primary care," a fee paid straight to the practice for a fixed set of services.
Who delivers it
The city contracts with Chicago's community health centers, the federally funded clinics that took over the city's own primary care clinics in 2012. They already have the doctors and the buildings, and federal rules already require them to see patients who can't pay. Members sign up with a participating center.
The monthly fee
The fee is set after a cost study with the community health centers that deliver the care.
Posted prices for screenings and scans
Mammograms, colonoscopies and MRIs stay outside the membership, because covering them for a flat fee would turn it into insurance. The city negotiates bundled cash prices with independent imaging and surgery centers, not hospital-owned ones, and posts them. You pay the center directly at the posted price. The target prices are: a screening mammogram, $50–$100, a screening colonoscopy, $1,000–$1,500, and an MRI, $300–$600.
Medicaid sign-up on the spot
Participating centers enroll eligible patients in CountyCare, Cook County's Medicaid plan, during the visit. Anything beyond primary care, like a specialist, surgery or a hospital stay, goes into Cook County's system instead of a new city one.
A mental health check at every visit
Every visit includes the standard depression and anxiety screening. If you screen positive or ask for help, you're handed off directly to the city's public mental health clinics, or to its 24/7 crisis centers if it's urgent.
Hospital prices you're already owed
Federal rules already require hospitals to post their prices. The city makes following those rules a condition of the local permits hospitals need, and builds a public tool for comparing prices.
What it doesn't cover
It doesn't cover hospital stays, surgery, emergency room care, labor and delivery, or cancer treatment. Those stay with Medicaid, private insurance or Cook County Health. If a screening finds something serious, you're referred to a specialist at a posted price or into CountyCare.
The bigger fight
The city pushes Springfield for a statewide public option, a government-run plan sold on the state's insurance marketplace. If the state won't act, the city seeks state permission for a Chicago public health plan. Both need state law, and Chicago Primary Care doesn't depend on either.
03
What it costs
Primary care at participating centers
Membership fees and Medicaid payments, plus any city contribution set by the cost study
Screenings and scans
Paid by the patient to the provider at the posted price; no city subsidy
Price contracts and transparency enforcement
City staff time
The policy publishes no cost figure yet. A budget will be built from the cost study with the participating centers and expected enrollment. It uses no new tax and no borrowing.
04
What it takes to make it happen
MAYOR AND CHICAGO DEPARTMENT OF PUBLIC HEALTH
Contract with community health centers, set the fee after a cost study, sign contracts with the imaging and surgery centers that post their prices, and run the hospital price tool.
COOK COUNTY
Work with the city so participating centers can enroll members in CountyCare. Cook County Health is run by the County Board, not the mayor.
CITY COUNCIL
Pass the ordinance that makes hospitals' local permits depend on following the federal price-posting rules, and approve any budget changes.
SPRINGFIELD
Chicago Primary Care itself needs nothing from Springfield. A statewide public option or a Chicago public health plan would need state law.
VOTERS
No referendum is needed.
05
Timeline
DAY ONE
I direct the Health Department to build Chicago Primary Care.
BEFORE LAUNCH
The city does a cost and capacity study with the community health centers and sets the membership fee from it.
YEAR ONE
The first community health centers and the first imaging and surgery centers are under contract, and baseline numbers are published.
YEAR THREE
The network of imaging and surgery centers with posted prices covers the whole city.
06
Where it's worked
Chicago today
In July 2012 the Chicago Department of Public Health handed its seven neighborhood primary care clinics over to community health centers.
SOURCE: CHICAGO DEPARTMENT OF PUBLIC HEALTH, PRIMARY CARE SERVICES 2012–2013 REPORT ↗
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Chicago today
The city counts 22 federally qualified health centers with more than 150 locations in Chicago.
SOURCE: CITY OF CHICAGO, HEALTHCARE ACCESS IN CHICAGO ↗
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Community health centers nationwide
Federally funded health centers can't turn anyone away for inability to pay. Patients at or below the federal poverty line get a full discount, and patients up to twice the poverty line get a partial one. Above that, there's no discount.
SOURCE: HRSA HEALTH CENTER PROGRAM COMPLIANCE MANUAL, CHAPTER 9 ↗
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Cook County
Cook County Health expects to provide about $485 million in free or discounted care in 2027, its highest in more than a decade, and expects 30% of its patients to be uninsured, up from 13% in 2023.
SOURCE: WBEZ, JULY 31, 2026 ↗
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Nationwide
Of the 23 nonprofit insurance co-ops created under the Affordable Care Act, all but three had failed by 2021. That's why Chicago Primary Care doesn't sell insurance.
SOURCE: MANAGED HEALTHCARE EXECUTIVE, FEBRUARY 2021 ↗
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Sources
Chicago Department of Public Health, Primary Care Services 2012–2013 report
City of Chicago, Healthcare Access in Chicago
HRSA Health Center Program Compliance Manual, Chapter 9
WBEZ, July 31, 2026
Managed Healthcare Executive, February 2021
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