Affordable Care Act enrollment in Illinois continues to drop, new state data shows

More than 92,000 people are no longer getting Affordable Care Act health insurance in Illinois, including a majority who were dropped because they didn’t pay their monthly premiums, according to new state data.This lowers the number of people buying health insurance through the state’s marketplace exchange, Get Covered Illinois, than initially thought — driven by people who likely couldn't afford their plan. Overall, enrollment now stands at 373,065, which includes those who signed up after open enrollment closed for most people. This is a nearly 15% drop from the state’s record high of 437,892 in February 2025, according to data from KFF, which conducts health policy research and polling.About 64% — or about 59,000 people — were disenrolled from their health insurance plan as of May 31 this year because of nonpayment, according to the state data. This year saw a higher percentage of people disenrolled for nonpayment since at least 2020, according to the state.Another 28% of enrollees dropped coverage because they gained insurance another way or moved out of state.In a statement, Get Covered Illinois said the increased costs in insurance led to one of the largest marketplace enrollment declines in nearly a decade because of federal policies.“Federal policies implemented by the Trump Administration and Congressional Republicans have left Illinoisans facing unprecedented rising health care costs,” the statement read. “... As a state-based marketplace, Get Covered Illinois was able to blunt some of the decline through premium alignment strategies and public outreach and enrollment assistance, but the Trump Administration's federal actions will continue to impact our residents’ access to affordable health care coverage.”The enrollment decrease in Illinois for nonpayment mirrors national figures. Earlier this year, the Wall Street Journal reported that about one in seven people across the country didn’t pay their premiums through the Affordable Care Act.Advocates say this is what they feared would happen when Congress last year did not extend enhanced tax credits that dated back to the COVID-19 pandemic. Those enhanced tax credits had made health insurance through the exchange more affordable, according to Kathy Waligora, a leader with the Protect Our Care Illinois. The tax credits were at the center of last fall’s historic government shutdown, though lawmakers never were able to gain enough support to extend them.“It was really exactly what we expected, and really concerning to see the scale,” Waligora said. “I think probably the most disappointing part is people wanted to be insured or they allowed themselves to be autorenewed and they couldn’t remain insured because of the cost of premiums.”The state’s data shows that even with the expiration of those tax credits, about 85% of enrollees continue receiving some other form of financial assistance. Still, most of those dropped from their health care plan have annual incomes ranging from $23,475 to $48,225, according to state data.Obamacare monthly premiums in Illinois rose by 25% this year, but that's still not as much as expected. State officials had originally predicted enrollees would see an average increase of 78%.Waligora credited the state with trying to mitigate changes to the Affordable Care Act by, for example, extending the open enrollment period and trying to provide more information about different types of healthcare plans. Still, she described the lower enrollment numbers as a “shocking change” reflecting broader affordability issues in health care.“We ignore this really loud signal we’ve gotten with the number of people disenrolling, likely going uninsured, because the marketplace coverage is unaffordable, if we don’t act on that, it’s going to have this ripple effect in the system,” Waligora said.

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