Prairie State Wire

Governor JB Pritzker has signed new legislation in Illinois to establish a state-based marketplace (SBM) for health insurance and implement rate review laws aimed at protecting consumers from unjustified premium increases. This initiative will provide the state with more control over its health insurance exchange, enabling better service to uninsured communities.

The Illinois Department of Insurance (DOI) and the Department of Healthcare and Family Services (DHFS) are tasked with executing this new plan, working in tandem with all state medical assistance programs. Governor Pritzker expressed his commitment to enhancing government efficiency and responsiveness, stating, "Operating our own healthcare marketplace gives us the dexterity to offer more enrollment windows...and protect Illinoisans from any future changes in federal policy that seek to undermine access to affordable healthcare."

Lieutenant Governor Juliana Stratton highlighted that Illinois now joins over three dozen states with similar authority in individual and small group health insurance markets. She noted this as a victory for consumers and a testament to collaborative efforts within the General Assembly.

Currently, Illinois utilizes the federal platform for the Affordable Care Act (ACA) Marketplace, incurring fees that will now be redirected to fund the new SBM under legislation HB 579. The transition is set for completion by 2026, allowing consumers to begin enrolling through the state's platform during the ACA Open Enrollment Period starting November 1, 2025.

Additionally, the newly signed rate review bill (HB2296) enhances consumer protection by mandating insurers provide detailed rate-setting information. The DOI can now approve or disapprove rates deemed unreasonable, thereby increasing transparency for both consumers and small businesses.

State Senator Ann Gillespie emphasized that establishing a state-based marketplace reflects an ongoing commitment to accessible healthcare: "I am pleased to see these measures become law...driving down costs and ultimately improving the overall well-being of our communities." House Majority Leader Robyn Gabel echoed this sentiment, underscoring efforts toward making healthcare independent of federal politics.

Representative Bob Morgan stressed that regulators' newfound power could have historically saved millions in insurance costs for families and businesses. Senator Laura Fine pointed out how previous lack of regulation allowed unchecked rate increases.

These legislative advancements aim not only at affordability but also increased accessibility across diverse demographics in Illinois. State Senator Napoleon Harris III remarked on reducing barriers through outreach efforts in underserved areas. Elliot Richardson from the Small Business Advocacy Council praised lawmakers' proactive steps toward cost stabilization.

Citizen Action Illinois Co-Director William McNary hailed these developments as vital relief against rising premiums while improving access and outcomes statewide. IDOI Director Dana Popish Severinghaus outlined benefits such as tailored enrollment periods catering specifically to state needs.

HFS Director Theresa Eagleson concluded by expressing hopes for a seamless customer experience across Medicaid or ACA plans through phased responsibilities transitioning from federal oversight.