Illinois consumers may face sticker shock when they shop for health insurance plans on the state\u2019s Affordable Care Act exchange this fall \u2014 with most companies proposing double-digit-percentage price increases as they grapple with uncertainty about changes at the federal level.<\/p>\n
Blue Cross and Blue Shield of Illinois, which has 238,000 Illinois residents on its exchange plans, is proposing an average rate increase of 27% across its individual exchange plans in Illinois.<\/p>\n
UnitedHealthcare of Illinois, which has about 32,000 Illinois residents on its exchange plans, is proposing an average rate increase of nearly 21%.<\/p>\n
Celtic Insurance Co.\u2019s most recently submitted proposal would raise rates by an average of nearly 39%. Celtic has about 111,000 Illinois residents on its Ambetter exchange plans.<\/p>\n
Several insurers are also pulling out of the exchange in Illinois for 2026. Aetna CVS Health, Health Alliance and Quartz will no longer offer exchange plans in Illinois next year, and Cigna Healthcare of Illinois will no longer sell marketplace plans in Cook County, though Cigna plans will be available in other parts of the state.<\/p>\n
In filings with the state, insurance companies blamed the price increases on growing health care costs and increasing use of health care services. They also assumed in their calculations that enhanced tax credits that many people now use to help lower their monthly premiums for exchange plans will expire at the end of this year \u2014 a situation that experts say would likely cause some healthy individuals to forgo insurance altogether, driving up costs across the board.<\/p>\n
Some insurers also mentioned a new federal rule that will shorten the annual open enrollment period for exchange plans. UnitedHealthcare of Illinois said uncertainty surrounding tariffs on pharmaceuticals also affected proposed rates.<\/p>\n
Blue Cross and Blue Shield of Illinois said in a statement to the Tribune that the proposed rates \u201creflect industry-wide changes to the market.\u201d UnitedHealthcare of Illinois and Centene Corp., which is behind Ambetter plans in Illinois, did not provide comment.<\/p>\n
\u201cAt the end of this day, all of this policy uncertainty that\u2019s driving up premiums for the next year, the consumer is the one who\u2019s going to have to face those prices, they\u2019re the ones who are going to have to front that money,\u201d said Matt McGough, a policy analyst in KFF\u2019s Program on the Affordable Care Act. KFF is a nonprofit organization focused on health policy.<\/p>\n
The Illinois Department of Insurance placed the blame for the higher rates squarely on President Donald Trump.<\/p>\n
\u201cDriven by Trump\u2019s harmful budget bill that\u2019s kicking people off Medicaid, making insurance less accessible, and exacerbating America\u2019s already broken healthcare system, states across the nation \u2014 including Illinois \u2014 are facing significant increases in insurance premiums through the marketplace,\u201d the department said in a statement. \u201cTrump\u2019s harmful policies will result in more uninsured Americans, which drives up costs up for everyone.\u201d<\/p>\n
In a statement, however, the federal Centers for Medicare and Medicaid Services blamed former President Joe Biden. The statement said that under Biden, uncertainty for insurers increased because of policies that led to more people enrolling in exchange plans and because the exchange\u2019s eligibility and verifications systems were weakened, which \u201cled to massive amounts of fraud and improper enrollments.\u201d<\/p>\n
\u201cCMS remains committed to ensuring coverage under the Affordable Care Act remains accessible, affordable, and actuarially sound,\u201d according to the statement.<\/p>\n
In Illinois, a record 466,000 people<\/a> selected exchange plans this year, according to KFF. Most people in Illinois get health insurance through their employers, Medicare or Medicaid. The Affordable Care Act exchange provides an option for people who don\u2019t get insurance through employers and who don\u2019t qualify for Medicaid or Medicare.<\/p>\n Illinois residents may begin signing up for plans at the beginning of open enrollment Nov. 1 on the state\u2019s new exchange at GetCoveredIllinois.gov<\/a>. Illinois recently gained approval<\/a> from the federal government to transition to a state-run exchange rather than use the federal one at HealthCare.gov<\/a>.<\/p>\n Illinois regulators must still approve the proposed rates before they\u2019re finalized. In 2023, Gov. JB Pritzker signed a bill into law<\/a> giving Illinois regulators the power to reject or modify proposed price increases for individual and small business health insurance plans, such as those sold on the exchange, if they deem them \u201cexcessive, unjustified or unfairly discriminatory.\u201d A spokesperson for the state insurance department said in an email Thursday the proposed rates are still being evaluated.<\/p>\n The proposed price increases in Illinois follow a national trend. Insurers across the country proposed a median increase of 18% for next year for many of the same reasons cited by companies selling insurance in Illinois, according to an analysis by the Peterson-KFF Health System Tracker<\/a>. It\u2019s the largest proposed rate increase since 2018<\/a>, according to the analysis.<\/p>\n \u201cInsurers are setting 2026 premiums amid this fog of uncertainty,\u201d McGough said. \u201cThey\u2019re unsure what policies will be passed, what will the marketplace look like next year, so a lot are building in these price hikes to play it safe and be conservative.\u201d<\/p>\n One of the biggest uncertainties is whether Congress will vote to extend enhanced tax credits that many people use to lower their monthly premiums. Many people who choose exchange plans have long qualified for tax credits based on their income. Those subsidies were expanded with the passage of the American Plan Rescue Act in 2021 and then extended through 2025 by the Inflation Reduction Act.<\/p>\n But it\u2019s now unclear whether the Republican-controlled Congress will vote to extend those enhanced subsidies beyond this year. Many Republicans have long criticized the Affordable Care Act as flawed and too costly, and Trump famously tried to eliminate it during his first term.<\/p>\n If Congress does not extend the enhanced subsidies, many people will still likely receive tax credits but they may be smaller than the credits they get now. Others who make larger amounts of money may no longer get the credits at all.<\/p>\n The expiration of those enhanced tax credits would likely drive some healthier people away from exchange plans, experts say. People who are healthy may decide having health insurance isn\u2019t worth the higher cost.<\/p>\n