Illinois consumers who purchase health insurance through the Affordable Care Act exchange may face another year of double-digit premium increases, as the state’s largest insurers have proposed significant rate hikes for 2027. The proposed increases, filed with state regulators, reflect a combination of rising medical costs, changes in federal subsidy policies, and a shrinking risk pool that continues to pressure the individual insurance market.
Blue Cross and Blue Shield of Illinois, the state’s largest health insurer, has proposed an average price increase of 14.9 percent across its exchange plans, according to filings with the Illinois Department of Insurance. UnitedHealthcare of Illinois is pitching an average 12.4 percent increase, and Oscar Health Plan has proposed an average 12.7 percent increase. Celtic Insurance Co., which offers Ambetter plans on the exchange, is proposing an average 9.2 percent jump.
According to The Chicago Tribune, the proposed increases in Illinois are in line with national trends. Insurers on exchanges across 16 states and Washington, D.C., are proposing a median premium increase of 14 percent for next year, according to an analysis by KFF, a nonprofit organization focused on health policy.
Most Illinois residents obtain health insurance through their employers, Medicare, or Medicaid, but each year hundreds of thousands who do not have access to those options sign up for exchange plans. For those consumers, the proposed rate increases could mean significantly higher monthly premiums, potentially putting coverage out of reach for many.
In their filings with the state, insurance companies blamed the proposed increases on rising medical costs and, in some cases, changes at the federal level that have led to fewer people paying for exchange plans. At the end of 2025, enhanced subsidies that had helped offset the costs of the plans expired after Congress failed to reach an agreement to extend them, an issue that was at the heart of last year’s government shutdown.
Though many consumers continue to receive subsidies this year, the subsidies are often not as large as in the past and fewer people are eligible for them. Illinois consumers who bought insurance on the state’s exchange, Get Covered Illinois, are paying 26 percent more for coverage on average in 2026 than they did the previous year, according to the Tribune.
The shrinking enrollment is compounding the problem. In the first few months of 2026, approximately 92,000 Illinois consumers lost or dropped their exchange plans, according to Get Covered Illinois. Advocates for the exchanges fear that many of those who drop their plans are healthier people whom insurers rely on to help balance out the costs of covering sicker individuals.
“As some healthier individuals opt out of coverage, remaining members utilize health care services more frequently,” Blue Cross and Blue Shield of Illinois said in a statement about the proposed increases. The insurer said the proposed jumps reflect the rising cost of care, increased use of medical services, and the increased medical complexity of its members. In Illinois, Blue Cross has more than 294,000 people on its individual ACA plans.
UnitedHealthcare of Illinois said proposed price increases are being driven by higher hospital prices, increased use of medical services, and rising specialty drug costs. More than 59,000 people in Illinois have UnitedHealthcare individual plans, according to the company’s filing.
Kathy Waligora, deputy director of external affairs for EverThrive Illinois, an organization focused on reproductive justice, said the proposed increases are disappointing but not surprising given changes at the federal level. “The medical care folks are receiving is more expensive and because of the loss of tax credits and general cost of living increase, we’ve seen more people be forced to go without health insurance,” said Waligora, who is also a leader of Protect Our Care Illinois, a coalition of organizations working to defend Medicaid and the Affordable Care Act.
“With more and more folks becoming uninsured, with things becoming more and more expensive, health insurance is going to continue to go up unless we do something,” Waligora added.
Illinois regulators must still approve the proposed rates before they are finalized. Under Illinois law, regulators can reject or modify the proposed price increases if they deem them “excessive, unjustified or unfairly discriminatory.” The review process typically concludes in the fall, with final rates announced before the annual open enrollment period begins in November.
The rate increases pose broader challenges for Illinois businesses, many of which are already struggling with rising healthcare costs for their employees. While ACA exchange plans are primarily used by individuals who do not have access to employer-sponsored coverage, the overall trend of rising medical costs affects all insurance markets. For Chicago-area businesses, the increases could mean higher costs for both employer-sponsored plans and individual coverage options for employees who do not qualify for company plans.
The proposed rate hikes also come as Illinois receives low marks for business friendliness in national rankings. According to a recent CNBC ranking cited by Crain’s Chicago Business, the state continues to lag behind competitors in categories that matter to business decisions, including the cost of doing business and healthcare affordability.
