Illinois Will Transition from a Federally Facilitated Marketplace to a State-Based Health Insurance Exchange

July 14, 2023

Illinois is set to create its own state-based health insurance exchange. In other words, our state will run its own Affordable Care Act (ACA) health insurance marketplace for Illinois residents to buy individual and family health insurance plans. Since the ACA was enacted, Illinois has used the federal exchange platform to facilitate the purchase of health insurance, in lieu of developing a state platform.

At the end of June, Governor Pritzker signed House Bill 0579 into law that will transition Illinois from Healthcare.gov to a state platform. Under the new law, the Department of Insurance will manage the “Illinois Health Benefits Exchange” using the federal platform by plan year 2025 and as a state-based exchange by plan year 2026.

Nationwide, Illinois will become the 19th state to operate its own Affordable Care Act exchange.

Once implemented, Illinois could also provide more opportunities for residents to purchase insurance plans by offering additional open enrollment periods, such as in the event of a disaster or if a big employer leaves the state. Currently, consumers can only enroll in exchange plans during an open enrollment period or if they experience certain life changes, such as the birth of a child or job loss. A state platform also provides other flexibilities and customization not offered through the federal exchange.

ISMS supports reducing the number of individuals without health insurance and increasing the affordability and equity of healthcare in Illinois.