Potential Health Insurance Price Hikes in Illinois
This fall, consumers in Illinois might experience significant price increases when shopping for health insurance through the state’s Affordable Care Act Exchange. Many insurance companies are reacting to uncertainties at the federal level with proposed double-digit hikes in premiums.
Illinois Blue Cross and Blue Shield, which serves about 238,000 residents in its exchange plans, is suggesting an average rate increase of 27% for their individual plans. United Healthcare, on the other hand, serves approximately 32,000 residents and is proposing an average increase of around 21%. Celtic Insurance Co. anticipates an even greater average increase of about 39%, affecting roughly 111,000 individuals enrolled in its Ambetter plans.
Additionally, several companies are opting out of the Illinois exchanges in 2026. For instance, AetnaCVSHealth, Health Alliance, and Kimartz will no longer offer exchange plans next year, while Cigna will cease to sell plans in Cook County but will remain active in other regions of the state.
In their state submissions, insurance companies criticized rising prices due to heightened healthcare costs and increased service usage. They also indicated assumptions that tax credits helping lower monthly premiums might be enhanced by the end of the year.
Some insurers pointed to new federal regulations that are shortening the annual open enrollment period for exchange plans as a contributing factor to their proposed increases. For example, United Healthcare highlighted uncertainties related to drug tariffs as influencing their prices.
Illinois Blue Cross and Blue Shield noted that their suggested fees are in line with broader industry shifts. United Healthcare and St. Naine, which oversees the Illinois Ambetter plan, did not provide further comments.
A representative from KFF, a nonprofit focused on health policy, mentioned that all this uncertainty regarding policy will ultimately be pressure on consumers as they face higher costs. The Illinois Department of Insurance hinted that President Trump’s previous policies are leading to rising premiums, suggesting they exacerbate the problems in the healthcare system.
In a contrasting statement, the Federal Centers for Medicare and Medicaid Services criticized former President Biden, claiming that policies under his administration increased uncertainties for insurers and resulted in fraudulent activities affecting exchange registrations.
This year, around 466,000 Illinois residents opted for a replacement plan, according to KFF. Most residents receive health insurance through their employers or programs like Medicare and Medicaid. The Affordable Care Act Exchange is designed for those not covered by employer-sponsored insurance or who do not qualify for Medicare or Medicaid.
Open enrollment for new plans begins on November 1st through GetCoveredIllinois.gov. Illinois recently received federal approval to transition to national exchanges instead of relying on federal programs like Healthcare.gov.
Before these rate hikes can take effect, Illinois regulators will need to approve the requests. Governor Pritzker signed a bill earlier this year allowing state regulators to deny or amend proposed rate increases if deemed excessive or unfair. A spokesperson mentioned that the proposed fees are still under review.
The suggested increases in Illinois reflect trends seen nationally, where insurance companies across the U.S. are proposing a median hike of 18% due to similar reasons cited by Illinois insurers. This marks the largest proposed increase since 2018.
According to McGough, insurers are setting their premiums amid a heavy fog of uncertainty, unsure of which policies will be enacted or the market conditions for the coming year. This reflects a cautious approach to price adjustments.
One major point of uncertainty remains whether Congress will choose to extend enhanced tax credits that many rely on to lower their premiums. The American Rescue Plan in 2021 expanded these credits, which were later prolonged until 2025 by the Inflation Reduction Act. However, it remains unclear if the Republican-controlled Congress will agree to extend these enhancements.
If these tax credits are not continued, many could still receive some assistance, but it might be less than what they currently get. Higher-income individuals might find themselves ineligible altogether.
Experts caution that the expiration of these enhanced tax credits could lead to healthier individuals opting out of exchange plans, which could hurt overall enrollment. Healthy individuals are generally less costly to insure, and their absence may negatively impact the balance of risk for insurers. KFF estimates that if the expanded subsidies lapse, premium payments for Illinois Exchange Plans could spike by 61% in 2024.
Stephanie Altman, director at the Schreiver Center on Poverty Law, remarked that rising costs will pressure many households and possibly lead them to forgo health insurance altogether. However, she emphasizes the importance of exploring different plan options, as many might be surprised by the financial aid available to them.
McGough suggested that individuals might consider less expensive options, like bronze-level plans, which come with lower monthly premiums but increased out-of-pocket costs for services.
Illinois residents could also see more assistance in signing up for exchange plans this year. Starting October 1st, Get Covered Illinois will launch an updated customer support center and website. Additionally, the state allocated $6.5 million for navigators to facilitate enrollment in these plans.
By maintaining its own exchange, Illinois is better positioned to tailor health insurance offerings to its residents’ needs. This setup may also provide flexibility for transitioning between Medicaid and exchange plans as financial situations change, which could lead to opportunities for special enrollment periods.
Initially published: August 21, 2025, at 3:49 PM CDT
