The Illinois Department of Insurance finalized rates for 2026 health insurance premiums this month, exercising a new right to modify premium adjustments proposed by companies issuing small group or individual insurance plans through the Affordable Care Act.
Surprisingly, most premiums filed by insurers increased after the state’s reviewal, including nearly all remaining Affordable Care Act marketplace rates in Sangamon County. Architects of the state law that created rate reviews, including state Sen. Laura Fine, said they hoped the law would lead to lower monthly premium costs. The law gives the Department of Insurance the authority to disapprove or modify proposed adjustments for upcoming “unreasonable rate increases or inadequate rates.”
“It begins in 2026, when our marketplace is going to be run by the state, versus the federal government,” Fine told The Evanston Roundtable last year. “By putting rate review in place, we’re hoping that we’re going to see a reduction in the price of premiums moving forward, when this is all implemented.”
The Department of Insurance enlisted the consulting agency Risk & Regulatory Consulting, at the cost of $500,000, to review the rates, though the filings state “the ultimate decision regarding the reasonability of the filed rates is determined by the (Illinois Department of Insurance).”
What is rate review and how does it work?
In 2023, the Illinois General Assembly passed a law allowing the state’s Department of Insurance to modify or deny proposed premium rate increases from health insurers for small business and individual plans.
Pennsylvania, which only has about 300,000 more people than Illinois, used its rate review authority last year to decrease a large share of premium rates that insurers were seeking to charge recipients of various individual and small group plans.
The Pennsylvania Insurance Department had the authority to review rates for 30 individual and small group insurance plans, ultimately lowering 21 of them.
Insurers submit their proposed premium adjustments to the state health department – considering various demographic and geographic factors that play into setting health insurance rates – which then has the ability to review the companies’ proposals before accepting, denying or modifying the monthly rate charged to its citizens.
Understanding marketplace insurance and tax credits
The U.S. has long had the most expensive health care system in the world, which some argue is only getting more expensive due to the explosion of costly weight loss drugs.
For people under the age of 65, most 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 marketplace established by the Affordable Care Act provides another avenue to health care for those who work jobs without the benefit of insurance but make too much money to qualify for Medicaid. Almost half a million Illinoisans enrolled in those types of plans last year, with more than 100,000 new beneficiaries.
The Affordable Care Act also created more provisions to push small businesses – defined as having fewer than 50 employees – to insure their workers.
However, tax credits that made these marketplace plans reasonably affordable, according to the Center on Budget and Policy Priorities, are set to expire at the end of the year. 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 insurance enrollees may 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.
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The Department of Insurance, in its 2026 rate announcement, cited – and criticized – the federal budget as the main reason for rates dramatically increasing and said the expiration of those tax credits “is anticipated to result in a significant number of uninsured Americans.”
Gov. JB Pritzker, along with 17 other Democrat governors, signed a letter to congressional leaders in both the House and Senate last week urging Congress to extend the tax credits.
“If they expire, premiums will rise by thousands of dollars for many families, millions will lose coverage, and people will be forced to make impossible choices between paying for health care, rent or groceries. Hard-working American families, older Americans not yet on Medicare, small business owners, and rural communities – where marketplace coverage is often the only option – will be hit the hardest,” the letter states. “If Congress acts quickly, states can lock in lower premiums and spare families a wave of sticker shock this fall. If not, the damage will be felt for years.”
Read the letter in full here:
Get Covered Illinois, the state’s health insurance marketplace, has a frequently asked questions webpage about changes to finding insurance next year. Starting Oct. 1, Get Covered Illinois will have a customer assistance center to answer consumer questions.
Open enrollment begins Nov. 1 and ends Jan. 15, 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.
This article appears in September 25-October 1, 2025.
If you think healthcare is bad now, you really won’t like what’s on the horizon. The health insurance industry has been in a death spiral ever since Obamacare dealt it a fatal blow, and it won’t be long before the health insurance industry is totally extinguished.
Illinois will be one of the first states to chase away all insurers, and the health insurance industry will be replaced by some type of “medicaid for all” scheme which will turn every doctor visit into a trip to the DMV.
The commies will get exactly what they have been crying for, and they will get it good and hard.
If you think wait times are long now, you will be amazed when doctors start fleeing Illinois for better compensation elsewhere and you will be lucky to get an appointment with a nurse practitioner without waiting for 6 months.
Thanks Obama!
Unfortunately, you may very well be correct. It is a concern I have had for a number of years.
You can know it’s correct by just looking at what Canadians have to deal with. Need to see a specialist? They will fit you in sometime next year.
The commies who are yearning for socialized healthcare love to talk about how socialized healthcare is “free” but they all neglect to mention that these countries all pay significantly more in taxes.
And the cherry on top is when some bureaucrat decides that the government won’t be paying for your procedure. Maybe you’re too old, too sick, or the government doesn’t like your political opinions. At least when insurance companies refuse to pay, you can still get treated.
I totally agree! If you can’t afford it or don’t have insurance, just don’t get sick!
Hi Hot Dog Enjoyer,
I understand that in our modern world people struggle to remember anything that happened more than 2 years ago.
But, before Obamacare, poor people had multiple ways to receive medical treatment. Of course, navigating a patchwork of charity programs/free clinics is not as easy as forcing the middle and upper class subsidize your medical care, but care was absolutely available.
Before Obamacare, a lower-middle class person could easily afford a high-deductible “catastrophic” insurance plan which would prevent them from going bankrupt in the event of a significant medical emergency. You could buy this plan for less than $100 per month.
Now, because of Obamacare, the health insurance industry is in an irreversible death spiral which can only lead to one result: complete socialized health care.
The result of socialized healthcare will be obvious, because you only need to look around the world to other countries with socialized healthcare to see what’s coming: significant increase in wait times, a significant reduction in the quality of care, and government bureaucrats deciding who gets treated and who doesn’t.
What? I said I agreed with you. There’s no reason for the wall of text.
Hi Hot Dog Enjoyer,
No, you’re using sarcasm to attempt to make some type of point that people who are unhappy with Obamacare don’t care about poor people. Which isn’t true.
They throw around a bunch of words to frighten people into thinking they are the saviors of the world
Hot dog enjoyer….listen to me…be nice to people don’t be a
BU L L Y!!!!°
DONT BE MEAN!!!!
BE NICE TO MR. BURGERMAN!!!! HE IS A PERSON
WHO TELLS IT LIKE IT IS!!!!!!
THANKS OBAMA!!!!!!!!!
Unadalterated balderdash.
For profit health care is unsustainable. We are the only civilized country in the world where profits come before health in healthcare. Facts matter, please start to embrace them before publishing Fox Entertainment talking points.
1. America pays 75% more per citizen for healthcare than Western Europe
2. Americans die sooner and are less healthy than Western Europeans
3. Western Europe has single payer systems
4. American employer sponsored health insurance funding is an outdated artifact of WW2 benefit programs
5. Obamacare slowed the ratre of medical inflation
6. The GOPs insistence on not providing oversight on mergers and acquisitions has allowed megacorporation hospital systems, pharmaceutical companies, and insurance companies to drive out competition and increase profitt margins.
The GOP leads the Democrats by 7 percentage points on the economy, 13 points on immigration and a whopping 22 points on crime. You’ve got to admire how shameless Pritzker is. No rational person can believe that Democrats are better on crime and immigration.The guy has the ability to say absolutely anything. If lying were an olympic sport, this guy could win the gold medal. Luckily for him, the democrat voters are so checked out and/or delusional that he will continue to get away with it. They literally let criminals run rampant to do what they do best, commit crime, and then cheer it on. But at the same time, if the candidate is Newsom or whomever then the same applies. 30 second montages of the candidate and their state/city/whatever back and forth, don’t do reruns just put out a different one every day if not every morning+afternoon+evening. It sounds like the solution presented in this report is not to change the democrat platform, but instead to be deceptive and dishonest when speaking to people who disagree with you. For example, pretend to be against abortion if it helps you to get elected, and then vote for abortion when you get in office. This strategy would be repulsive to people with morals and standards, so the democrats should warm right up to it.
You lost the election, so you wrote a book. You just want to make more money. You are an embarrassment to women all over the US.
So i guess no one listens to the cherry poppin’ daddies anymore?
ZOOT SUIT RIOT!!!!!!!