Marketplace health insurance deadline nears

Health expenses are booming and insured consumers could feel the full force of those rising costs in 2026 as premium tax credits that made health insurance plans affordable for millions of Americans are set to expire. Open enrollment ends Jan. 15, though "Illinoisans who want their coverage to begin Jan. 1 must enroll by the extended deadline of Dec. 31," according to Get Covered Illinois, the state's new health insurance marketplace.

Congress, in recent weeks, tried and failed to pass multiple measures that would have extended the tax credits through at least 2026.

Most Americans under the age of 65 rely on a job to provide health insurance from private insurers. For those with special circumstances or the inability to work, government-funded Medicaid becomes an option.

The insurance marketplace established by the Affordable Care Act, or ACA, provides a third avenue to health care for those who work jobs without the benefit of insurance or make too much money to qualify for Medicaid. Almost half a million Illinoisans enrolled in those kinds of plans last year, with more than 5,500 Sangamon County residents enrolling in such plans, according to the Centers for Medicare & Medicaid Services.

However, tax credits that made these marketplace plans reasonably affordable, according to the Center on Budget and Policy Priorities, will not be included in next year's plan as Congress failed to approve a bill to extend the credits. Almost 400,000 people on marketplace insurance in Illinois qualified for those credits, saving recipients an average of more than $500 per month, according to KFF.

The lack of tax credits means enrollees of ACA plans will feel the brunt of premium rate hikes for the first time in years. The average premium that marketplace enrollees in Sangamon County were charged last year was near $850 per month before tax credits brought the average down below $200 per month, according to the Centers for Medicare & Medicaid.

More than 100,000 people in Illinois who were previously covered by ACA plans are projected to be uninsured in 2026 as a result of tax credits expiring, according to estimates by the nonpartisan policy nonprofit Urban Institute.

Recipients of Deferred Action for Childhood Arrivals, or DACA, are also no longer eligible for marketplace plans after a federal rule change submitted earlier this year by the U.S. Department of Health and Human Services.

Get Covered Illinois, the state's health insurance marketplace, has a frequently asked questions webpage about changes to finding insurance next year. Illinois has a network of navigators that can provide free, in-person assistance any time of the year. Springfield has two such navigators: Springfield Urban League and Central Counties Health Centers.

Visit getcovered.illinois.gov to schedule an appointment or view plans.

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