Illinois Enacts Critical Consumer Protection for Affordable Health Care

Everyone deserves access to affordable, comprehensive health care, no matter their income, race, gender, or where they’re from. People need to stay healthy so they can work, take care of their families, and be active members of their communities. 

Thanks to health care advocates, Illinois enacted legislation this year to have power over health insurance prices by strengthening the state’s rate review law. A strong rate review process protects individuals, families, and small businesses from unreasonable premium rate hikes and sets accountability standards for how insurers determine rates. States such as Rhode Island, New York, and the District of Columbia have saved millions for residents and businesses by using robust review processes. 

“For too many people in Illinois, medical costs are too high, deepening racial inequities that affect communities of color the most,” said Stephani Becker, associate director of health care justice at the Shriver Center on Poverty Law. “This bill holds insurance companies accountable, prevents unnecessary hikes in premium rates, and brings more transparency to the process for reviewing rate increases. We thank our partners, legislators, and the Pritzker administration who worked tirelessly on this critical consumer protection for Illinois families.”

Under the Affordable Care Act (ACA), insurers must submit proposed premium rates to state and/or federal regulators. State agency authority in regulating these numbers vary from state to state. Regulators are responsible for making data and justifications around an insurer’s proposed rates public and accessible to consumers.

In Illinois, insurers typically go through several steps in the rate review process. During the Illinois General Assembly’s spring 2023 session, the Shriver Center advocated for the signing of a bill (HB 2296) along with the Protect Our Care – Illinois coalition. With the passage of this bill, Illinois joins 41 other states as a “prior approval” state. The Illinois Department of Insurance now has the authority to approve, reject, or modify the rates before they go into effect — a move necessary to shield consumers, particularly Black and brown communities. 

Goals to strengthen state’s rate review processes should include: 

• Ensuring state agencies have the authority to reject, modify, or approve proposed health insurance premium rates. 
• Creating a rate review process that includes assessment of affordability, public representation in the review process, and public sharing of any proposed changes. 
• Using data to create estimates of potential price hikes that are both reasonable and justifiable. 
• Keeping cost sharing as low as possible for people with modest incomes. 

It is important that regulatory bodies bring fairness to the health insurance market. Work by organizations like Families USA are pivotal in the fight to make health care more transparent and inclusive, particularly through research on the rate review process. Read more in a newly released report by the Shriver Center and Families USA.  

The Shriver Center continues to work with policymakers, health care practitioners, directly impacted individuals, and partner organizations to make it easier for people to get and keep the health coverage they need.