Illinois Takes Steps to Establish its Own Obamacare Marketplace

Gov. J.B. Pritzker supports new state legislation to establish an Illinois Health Care Insurance Exchange, in an effort to safeguard an important Affordable Healthcare Act provision in Illinois if future federal leaders decide to rollback parts of this landmark law.

Illinois’ proposed legislation is being introduced as amendments to its Administrative Procedure Act or calls for Illinois to establish its own one-stop shop to provide health insurance. The federal marketplace established in 2010 under the ACA of former president Barack Obama requires that states pay a fee. This platform allows every American to purchase a health insurance plan. Illinois could control its market for health insurance and protect itself from federal policy changes by creating its own exchange.


Pritzker is also protecting Illinois’ marketplace if a Republican president decides to reduce federal resources for the marketplace. Pritzker’s office points out that funding for enrollment navigators decreased under the former administration of Donald Trump.

Jordan Abudayyeh, Pritzker’s spokeswoman, told Crain’s that “our marketplace will be protected from those who try to undermine affordable health care.” “Moving (to a state-based marketplace) will insulate Illinois from any changes in federal administrations that may try to sabotage this marketplace.”

The Illinois Legislature is currently working on amending the bill. The bill gained new sponsors on Tuesday, and Pritzker’s office said he would “love to sign” the bill this summer.

Pritzker stated that the adoption of a state based insurance marketplace is a step forward in Illinois in creating a system where everyone who qualifies can receive the treatment and care they deserve.

Illinois uses the current federal-state partnership exchange market, where residents can enroll through According to the Illinois Department of Insurance, this year’s number of Illinoisans who enrolled in a marketplace plan reached a record. Nearly 343,000 plans were selected, an increase of 6% over last year.

Last year, after the Supreme Court reversed Roe v. Wade which protected Americans’ rights to abortion in general, concerns about federal health policy and its impact upon states were heightened. Federal courts have also used an abortion pill since then.

In March, a Texas federal judge made major changes to the ACA by requiring that health insurance plans and employer-sponsored health care pay for certain preventive services.

In recent years, other states have also set up their marketplace exchanges. In January, 18 state exchanges had been created, according to the Centers for Medicare & Medicaid Services.

If Illinois legislation is approved, the full transition to a state-based health plan marketplace will take approximately three years. However, an initial version of the marketplace would be available by the fall 2020 enrollment period. Abudayyeh stated that a state-based marketplace for health plans would not affect current coverage options in Illinois. The state-based marketplace would include all ACA-approved health plans that are currently available to Illinois residents.

Pritzker’s office stated in a press release that a local exchange will also help the state identify and target Illinois’ underinsured or uninsured residents. The Illinois exchange will be run by the Department of Insurance, and the Department of Healthcare & Family Services which administers Illinois Medicaid.

Abudayyeh stated that “the hope (under a state-based market) is that Illinoisans enrolling in the marketplace will be able to easily find the plan that best suits them.” We can easily enroll you in a Medicaid plan if, for example, you sign up for an ACA plan and would be better off on a Medicaid-based plan.

Zarek Brot Goldberg, assistant professor at University of Chicago’s Harris School of Public Policy, said that if the legislation passed, Illinois would need to create a new system and website to distribute the plans, and hire staff to manage them.

He says that while bringing the exchanges in-house may be costly, Illinois will have a chance to protect itself from national whims and also make them more efficient.