Last week, the Chicago Tribune reported that more than 90,000 Illinois consumers have lost or dropped ACA marketplace coverage since February. Data obtained from Get Covered Illinois, the state’s official ACA health insurance marketplace, shows that enrollment has fallen by more than 20% since February 1.
Almost two-thirds of those who dropped coverage did so due to failure to pay their premiums, indicating that higher-than-expected costs are the likely culprit. The Tribune previously reported that Illinois ACA marketplace consumers paid an average of 26% more for coverage this year than they did in 2025.
Nearly half of adults with ACA marketplace coverage are small business owners, employees, or self-employed. A failure to address the ACA’s affordability crisis is thus a failure to support the small business community.
The SBAC called on Congress to extend the Enhanced Premium Tax Credits (EPTCs) at the end of last year. Given that the EPTCs seem unlikely to be reinstated, we are working on bipartisan state legislation to incentivize small business owners to reimburse employees who purchase coverage through the individual marketplace.
The SBAC is championing a bill in the Illinois Senate with 23 bipartisan co-sponsors that will provide two-year tax credits to small businesses that offer their employees a Health Reimbursement Arrangement (HRA). The bill will reduce administrative burden and create cost predictability for small business owners while expanding choice and flexibility and increasing access to quality marketplace coverage for their employees.
Illinois policymakers should fill the gap left by Congress and take the necessary steps to make health insurance more affordable for small business owners and employees. The health of our workforce depends on it.