Illinois Faces Decline in ACA Enrollment Due to Premium Non-Payment

According to recent data, over 92,000 individuals in Illinois have lost their health insurance coverage under the Affordable Care Act (ACA), primarily due to the non-payment of premiums. This reduction impacts those purchasing insurance through the state's marketplace, Get Covered Illinois, with current enrollment at 373,065. This figure is a decline of nearly 15% from a peak of 437,892 in February 2025, per the Kaiser Family Foundation (KFF).

Approximately 64% of those who lost coverage, around 59,000 people, were disenrolled due to nonpayment by May 31 of this year. This marks a significant increase in nonpayment-related disenrollments compared to previous years since 2020. Additionally, 28% ceased their coverage for reasons such as obtaining other insurance or relocating out of state.

Get Covered Illinois attributes the decline in marketplace enrollment to rising insurance costs, influenced by federal regulatory compliance requirements. In an official statement, they acknowledged efforts to mitigate the decline through premium alignment strategies and outreach programs but highlighted the ongoing impact of federal administrative actions on accessible healthcare coverage.

This trend is consistent with national patterns, as highlighted by the Wall Street Journal, indicating that about one in seven Americans failed to pay ACA premiums. Health advocates expressed concerns over this development, especially after Congress did not extend enhanced tax credits, which had initially made ACA coverage more affordable during the COVID-19 pandemic.

Kathy Waligora from Protect Our Care Illinois noted the lack of continued tax credits has led to financial strain for many enrollees, with most who lost coverage having annual incomes between $23,475 and $48,225. Despite this, 85% of current enrollees still receive financial aid. Waligora emphasized the reduced enrollment figures as indicative of broader affordability issues within the healthcare system.

In Illinois, ACA premiums rose by 25% this year, which is less than the initially predicted 78%. State efforts to adapt to changes in the ACA, including extending the open enrollment period and enhancing consumer information about available plans, have been acknowledged. Nonetheless, concerns persist regarding the ramifications of declining enrollment and the affordability of health insurance coverage.