Pritzker signs legislation authorizing a state-based marketplace for health insurance, rate review

CHICAGO, Ill. (WJPF) — Governor JB Pritzker has signed legislation authorizing a new state-based marketplace for Illinois, which gives state agencies additional tools to create a more consumer-focused health insurance exchange and better identify traditionally uninsured communities. The Governor also signed historic rate review legislation Tuesday, which will protect health insurance consumers from unfair rate hikes.

Illinois residents currently access the Affordable Care Act Marketplace using the federal platform which the state pays a fee to use. HB 579 will transition Illinois to a state platform, redirecting that fee to Illinois to fund the new state-based marketplace. The full state-based marketplace goes live for plan year 2026, and consumers will start enrolling via the Illinois platform during the ACA Marketplace Open Enrollment Period beginning November 1, 2025. Currently, the federal platform does not share real-time data, and the Illinois Department of Insurance must rely on federal reports with limited information regarding enrollment in ACA Marketplace coverage. The new legislation will help address that challenge, allowing Illinois to better target and serve uninsured communities.

The rate review bill signed into law, HB2296, is a piece of consumer protection legislation that aims to advance health care affordability. Illinois joins 41 other states in protecting Illinois consumers and small businesses from unfair premium rate hikes. For the first time, insurance companies will have to provide specific information about how they set their rates and the Illinois Department of Insurance will have the authority to approve, modify, or disapprove health premium rates that it determines to be unreasonable or inadequate in the individual and small group market. It also increases transparency for consumers and small business by adding reporting requirements for insurance companies, and gives Illinois Department of Insurance the data it needs to explain to consumers and small businesses why people pay what they pay in a yearly report.

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