Illinois health insurance

Five insurers offering 2020 coverage in Illinois; short-term plans are capped at six months and renewals are prohibited.

Health insurance in Illinois

This page is dedicated to helping consumers quickly find health insurance resources in Illinois. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Illinois health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Illinois; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of Illinois health insurance resources for residents.

The Illinois health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

Could Illinois be doing more to preserve the Affordable Care Act’s provisions? Compare its efforts to other state-level actions.

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

Illinois open enrollment period and dates

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 Illinois open enrollment period for plans effective in 2021 will begin November 1, 2020.

Five insurers are offering 2020 coverage through the Illinois exchange.

Read our full overview of the Illinois health insurance marketplace.

Illinois enrollment in qualified health plans

For 2020 coverage, 294,263 people enrolled in qualified health plans (QHPs) through the Illinois health insurance marketplace during the open enrollment period. As is the case in the majority of the states that use, 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 expansion 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 coverage 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 Illinois health insurance marketplace 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.

Medicare coverage and enrollment in Illinois

As of late 2019, 2,244,801 Illinois residents were enrolled in Medicare. 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 Her state health insurance marketplace updates are regularly cited by media who cover health reform and by other health insurance experts.

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