IDOI celebrates the 14th Anniversary of the Affordable Care Act (ACA) and Welcomes Recently Appointed State-Based Marketplace Director

Chicago, ILLINOIS, April 1 - The Illinois Department of Insurance (IDOI) celebrates the 14th anniversary of the Affordable Care Act (ACA) and welcomes the new Acting State-Based Marketplace (SBM) Director* who will help lead the SBM, also known as the Illinois Health Benefits Exchange.

The SBM is slated to start enrolling Illinoisans during the ACA Marketplace Open Enrollment Period beginning November 1, 2025. Governor Pritzker signed legislation last summer authorizing the SBM for Illinois to create a more consumer-focused health insurance exchange and better identify traditionally uninsured communities.

The ACA, enacted in March 2010, has provided access to comprehensive health insurance coverage for millions of Americans, including coverage for pre-existing conditions, contraceptives, and essential health benefits that cover preventive care and screenings, prescription drugs, and mental health and substance use treatment.

Last week, the Biden administration credited the ACA with advancing health coverage and equity in the United States, and in Illinois, Governor JB Pritzker is leading the fight for health insurance consumer protections and reforms.

Governor Pritzker's healthcare and coverage initiatives, along with enforcement actions through IDOI, include:

• The Healthcare Protection Act (HPA), first introduced in the Governor's FY25 Budget Address which aims to end unchecked rate increases for large group insurance companies, bans step therapy processes, bans prior authorization for in-patient adult and children's mental health care, and focuses on improving network adequacy.
• IDOI's promulgation of regulations strengthening network adequacy protections by setting patient to provider ratios, time and distance standards, and reporting requirements.
• IDOI's assessment of the first ever fine against an insurer for failure to properly update its provider directory in violation of the Network Adequacy and Transparency Act (NATA).
• IDOI's establishment of a NATA enforcement unit which investigates insurer networks and provider directory issues, including reviewing underlying contracts and identifying real-time violations.
• Signing historic rate review legislation, which will protect health insurance consumers from unfair rate hikes.
• Signing legislation codifying protections for preventive care services required under the ACA, including reproductive health care services.

"Our Governor has made clear his commitment to ensuring equitable access to healthcare and health insurance coverage for all Illinoisans, and his Healthcare Protection Act (HPA) builds upon that," said IDOI Director Dana Popish Severinghaus. "We recognize the ACA's role in providing consumer protections for health insurance coverage is unprecedented, and we will extend the reach of those benefits with the opening of our own State-Based Marketplace which Morgan Winters will oversee."

Winters, appointed by Governor Pritzker, brings more than a decade of experience to his new role leading the new SBM.***

"The record-high enrollment in ACA Marketplace health plans nationally and here in Illinois highlights the need for affordable health insurance coverage," said Acting Marketplace Director Morgan Winters. "I look forward to increasing consumer protections and coverage standards, and continuing to provide much-needed help to Illinoisans with advanced premium tax credits and cost sharing reduction payments to access the health coverage they need."

Get Covered Illinois (GCI), a division of the Illinois Department of Insurance, is the official health marketplace or "exchange" for Illinois consumers to purchase quality, affordable health insurance, facilitated by the federal government through the ACA Marketplace.

*Appointments pending confirmation by the Illinois Senate.