CHAMPAIGN — Open enrollment on the Affordable Care Act marketplace starts Saturday, Nov. 1, and average monthly premiums for 2026 plans are expected to more than double on average unless Congress extends subsidies that help cover those costs beyond this year.
Higher costs would mean many people would go without health coverage. The nonpartisan Congressional Budget Office estimates if the subsidies expire, four million people will lose their coverage from the health insurance marketplace and become uninsured.
That will have ripple effects throughout the community, said Claudia Lennhoff, executive director of the Champaign County Health Care Consumers (CCHCC), which hosted an event about the local impact of Marketplace changes at the Champaign Public Library Wednesday.
“When people lose health insurance, our health systems, the providers who provide the health care services, they end up with a lot of uncompensated care, and that can be really difficult, especially in rural areas,” Lennhoff said.
She said the uncertainty in the health insurance market is contributing to rising costs for consumers.
“The market is in flux, and health insurance insurers never want to see that,” Lennhoff said. “So there’s a sort of a situation where health insurance premiums are going up because of all the uncertainty, but the financial assistance resources that are tied to people’s income are going down.”
The ongoing government shutdown largely revolves around the debate over extending ACA subsidies.
Democrats in Congress have stated they will not pass a bill to open the government without extending those subsidies. Republicans insist the government should reopen first – and that there will be time for lawmakers to consider the issue afterwards.
One positive note in Illinois, Lennhoff said, is that the state is now running its own marketplace.
“In the past, when the Affordable Care Act was created and the marketplace was created, states were given the option of developing their own marketplace or partnering with the federal government to use healthcare.gov,” she said, “and so Illinois has been working on their marketplace, and this is the first year.”
Lennhoff said she has been contacted by people who’ve heard allegations of waste, fraud and abuse in the ACA marketplace.
“There’s a lot of disinformation about why this is happening,” she said. “…and let’s be clear, it’s hard to abuse these systems from a consumer perspective, because it’s pretty rigorous about showing your income and all of that. It’s not being abused.”
She said some proponents for the elimination of the enhanced premium tax subsidies say they don’t want undocumented immigrants to get that assistance – but Lennhoff noted people without legal status have never been eligible for these subsidies.
“This isn’t about undocumented immigrants. …It’s not about sound health policy. Because sound health policy would mean we cover everybody,” she said.
The CCHCC notes that while enhanced premium tax subsidies were not extended through the budget bill signed into law in July, regular premium tax subsidies are still available.
Open enrollment for ACA plans takes place from Nov. 1, 2025, through Jan. 15, 2026.
IPM Student Newsroom’s A. Oishii Basu contributed reporting.