State-based health insurance marketplace opens amid federal budget
stalemate
[October 18, 2025]
By Peter Hancock
SPRINGFIELD – People in Illinois who buy health insurance through the
Affordable Care Act marketplace are likely to see big increases in the
cost of their premiums next year, but state officials are encouraging
them to reach out for help before they decide to drop their coverage.
“We’re really encouraging people, don’t walk away. Come and talk to a
navigator,” Illinois Insurance Director Ann Gillespie said in an
interview this week. “Make an appointment to talk to a navigator,
because there are over 1,100 plans that we’re going to be offering on
the marketplace. There might be an option that will be affordable for
you.”
Open enrollment for the 2026 plan year begins Nov. 1 and runs through
Jan. 15. This year will be the first year in which Illinois residents
will use a state-based online platform, Get Covered Illinois, to shop
for their plans.
“Last year, we were a state-based marketplace, but on the federal
platform still. It was our transition year,” Gillespie said. “So last
year was technically the first year of the state-based marketplace. This
year, we’re on our own platform for the first time.”
Federal budget battle
The premium hike is the result of a federal budget change that was
included in President Donald Trump’s domestic policy agenda known as the
“One Big Beautiful Bill Act.” That provision ends the enhanced tax
credits that subsidize the cost of premiums for people who meet income
guidelines.
Premium tax credits have always been part of the Affordable Care Act
since it was passed in 2010 as a tool to reduce the out-of-pocket cost
of plans sold on the exchange. They were available to households with
incomes up to 400% of the federal poverty level, or $128,600 for a
family of four in 2025.
Congress first passed the enhanced credits in 2021 as part of the
American Rescue Plan Act, an economic package passed in response to the
COVID-19 pandemic. They were renewed in 2022 as part of another
pandemic-related law, the Inflation Reduction Act.
The ending of those enhanced credits is now at the center of the ongoing
federal budget stalemate in Congress, which prompted the partial
shutdown of the federal government that began Oct. 1.
That day marked the start of a new federal fiscal year, but so far
Congress has been unable to pass the spending bills needed to fund most
of the government’s day-to-day operating costs.
Impact in Illinois
In January 2025, an estimated 466,000 people in Illinois were covered by
ACA marketplace plans. Of those, Gillespie said, about 90% received some
amount of tax credit to subsidize their premiums. But she said ending
the enhanced credits could cause people’s out-of-pocket premium costs to
rise, possibly forcing many people to drop their coverage.
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Ann Gillespie, a former state senator who is now the state’s
insurance department director, is pictured at a news conference with
Gov. JB Pritzker and others in 2023. (Capitol News Illinois photo by
Andrew Adams)
“Premiums are going to go up nationwide as a result of this,” she
said. “People are going to be seeing premiums increased double,
triple – in some states they’re going to quadruple.”
“You can argue that they were just for COVID,” Gillespie said. “But
I look at it as, it was one more step into making sure we have
coverage for everybody in the country and taking it away now after
people have become dependent on it is really a cruel blow to people
that are facing price increases from inflation.”
State-based exchange
Before Gov. JB Pritzker named Gillespie to lead the Insurance
Department in 2024, she served in the state Senate and was the lead
sponsor of the 2023 legislation that called for setting up a
state-based exchange. Before that, Illinois residents had to use the
federal portal, HealthCare.gov, to enroll in ACA insurance.
Gillespie said that bill came about in response to federal policy
changes during the first Trump administration, which included
shortening the open enrollment period and reducing funding for
employing “navigators” who helped people find coverage plans to suit
their needs.
“The value of a state-based exchange is that you’ve got some
independence from the federal administration changes and the policy
shifts,” she said. “So, as a state-based exchange, you’ve got a
little more ability to customize the plan offerings for the
residents of your state. You have a little more leeway with setting
special enrollment periods.”
Gillespie said starting in 2026, there will be two additional
enrollment opportunities under the state-based exchange.
One will be a pregnancy open enrollment, she said, “so if you find
out that you’re pregnant in between open enrollments, we can have a
special enrollment period so you can get coverage.”
A second opportunity will be tied to filing individual tax returns.
“There will be a space on your tax return where you can check to
indicate that you’d like enrollment materials for the state-based
market,” she said.
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