The decision by a Texas federal judge to rule the Affordable Care Act unconstitutional could cost Cook County between $300 million and $800 million in annual federal subsidies annually and upend the health system’s service model, which now focuses on insuring Medicaid managed care patients through its CountyCare program and providing outpatient and preventive care.

Cook County Board President Toni Preckwinkle addresses the news media about the Cook County Health and Hospitals System. [A.D. Quig/The Daily Line]