Historic legislation creates Illinois insurance marketplace, protects consumers from unfair rate hikes

CHICAGO – Illinois residents will have more options when it comes to affordable, quality health insurance thanks to legislation from State Senators Ann Gillespie and Laura Fine. Gillespie’s bill creating a state-based health insurance marketplace and Fine’s legislation protecting consumers from unnecessary insurance rate increases have both been signed into law.

House Bill 579 establishes a state-based health insurance marketplace offering a variety of health insurance plans from different insurers. Illinois residents currently access the Affordable Care Act Marketplace using the federal platform which the state pays a fee to use. 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 law helps address that challenge, allowing Illinois to better target and serve uninsured communities.

“Today, we take a significant step forward in providing accessible and affordable health care for all Illinois residents. Establishing a state-based insurance marketplace reflects our unwavering commitment to ensuring everyone can find a high-quality plan tailored to their needs,” said Gillespie (D-Arlington Heights). “I am pleased to see these measures become law, empowering individuals to make informed choices, increasing transparency, driving down costs and ultimately improving the overall well-being of our communities.”

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 Nov. 1, 2025.

Through House Bill 2296, Illinois joins 41 other states in protecting 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 DOI will have the authority to approve, modify or reject health premium rates that are determined be unreasonable or inadequate in the individual and small group market. Through annual reports, consumers will gain a greater sense of transparency when it comes to what they pay and why.

“Health insurers in Illinois have been able to increase their rates with few guard rails, making purchasing insurance inaccessible to many working Illinoisans and small businesses,” said Fine (D-Glenview). “Under this law, the Department of Insurance will be able to reject unsubstantiated increases to make sure care is accessible and affordable for Illinois residents.”

The insurance rate review process will go into effect for plans purchased in 2026.