Health insurance in Illinois
- Illinois has a partnership health insurance exchange with the federal government.
- Open enrollment for 2020 health plans has ended, although Illinois residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
- Short-term health plans can be sold in Illinois with terms of up to six months.
- Five insurers offer 2020 coverage in the state’s individual market.
- About 294,000 people enrolled in private plans for 2020 through the Illinois exchange.
- Illinois adopted the ACA’s Medicaid expansion in 2014.
- The state’s CO-OP, Land of Lincoln Health, ceased operations in 2016.
The Illinois health marketplace
Illinois operates a partnership exchange with the federal government. That means the state runs Get Covered Illinois – which provides a website, in-person assistance, and a help desk – while Illinois residents enroll or make plan changes through HealthCare.gov.
Open enrollment for 2020 health plans has ended, although residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
Read our full overview of the Illinois health insurance marketplace.
Illinois enrollment in qualified health plans
294,263 people enrolled in qualified health plans (QHPs) through the Illinois exchange during the open enrollment period for 2020 coverage. As is the case in the majority of the states that use HealthCare.gov, enrollment peaked in Illinois in 2016, when 388,179 people enrolled.
Enrollment has declined each year since then, due to a variety of factors, including reduced federal funding for exchange marketing and outreach, higher premiums for people who don’t get subsidies, the elimination of the ACA’s individual mandate penalty, and the expansion of short-term health plans as an alternative to ACA-compliant plans.
Read more about the Illinois health insurance marketplace.
Medicaid and CHIP in Illinois
Medicaid expansion in Illinois was authorized in 2013 and went into effect in 2014. As a result, about 350,000 new enrollees were approved in just the first several months. A year later in 2015, total enrollments under Medicaid expansion in Illinois had reached 623,000. By August 2016, the total had exceeded 646,000, although it had dropped back down to just over 600,000 by mid-2018.
As of September 2019, 2.8 million residents of Illinois were covered by Medicaid/CHIP. That was 7 percent more than the enrollment total in late 2013, but it was down from 2.95 million in mid-2018.
Read more about Medicaid expansion in Illinois.
Short-term health insurance in Illinois
Illinois enacted legislation in 2018 that limits short-term health plans to six-month terms and prohibits renewals. The legislation was vetoed by the governor, but lawmakers overrode the veto.
Read more about short-term health insurance in Illinois.
How Obamacare is helping Illinois residents
Illinois has had relative success under the Affordable Care Act. Its uninsured rates have been nearly cut in half as more residents access coverage via subsidized private plans on the state’s exchange, and more than 600,000 people are covered under expanded Medicaid.
12.7 percent of the population was uninsured in 2013, according to U.S. Census data, and that had fallen to 6.5 percent by 2016, due primarily to the ACA. At that point, the national average uninsured rate was 8.6 percent. By 2018, the state’s uninsured rate had crept back up to 7 percent, mirroring a nationwide uptick in the uninsured rate under the Trump administration.
Other ACA reform provisions
The Affordable Care Act established a federal loan program, called the Consumer Operated and Oriented Plan (CO-OP) Program. The program is designed to increased consumer choice and expand competition by enabling new nonprofit health insurers to enter the market.
In Illinois, Land of Lincoln Health received more than $160 million in grant funds. But like most of the CO-OPs, Land of Lincoln struggled financially, and it ceased operations September 30, 2016. As of early 2020, only four ACA-created CO-OPs remained operational, out of 23 that began offering coverage in the fall of 2013.
Does Illinois have a high-risk pool?
Prior to the reforms the ACA brought to the individual health insurance market, coverage was underwritten in nearly every state, including Illinois. People with pre-existing conditions often found themselves ineligible to purchase private plans, or only able to get coverage that excluded pre-existing conditions.
The Illinois Comprehensive Health Insurance Plan (ICHIP) was created in 1989 to provide a coverage option for people unable to obtain private plans because of their medical history. Due to budget shortfalls, the plan stopped enrolling new members in September 2000, and applicants were placed on a waiting list. The program was able to reopen to new enrollment in the spring of 2001. The pool also briefly suspended new enrollment in the summer of 2009.
In 2001, the risk pool had about 5,700 members, but that number had grown to more than 18,000 by the end of 2010.
Under the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This reform measure has largely eliminated the need for high-risk pools, since medical history is no longer a barrier to obtaining coverage in the individual market.
ICHIP was still enrolling eligible HIPAA pool applicants, but stopped renewing traditional risk pool members’ coverage after April 30, 2014. They notified members and posted extensive data on their website explaining how to transition to an exchange plan.
Illinois Medicare enrollment
2,244,801 Illinois residents were enrolled in Medicare as of late 2019. 87 percent of the state’s Medicare beneficiaries are 65 or older, while the other 13 percent are under 65 and eligible for Medicare due to disability.
Medicare beneficiaries can choose between Original Medicare and Medicare Advantage. Compared with the national average, a smaller percentage of Illinois beneficiaries select Medicare Advantage plans. And as expected when Original Medicare enrollment is higher, a larger-than-average number enroll in stand-alone Part D prescription drug plans.
Health reform legislation in Illinois
Scroll to the bottom of the page to see what’s happening legislatively with healthcare reform in Illinois at the state level:
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.