on the Affordable Care Act for health insurance coverage may be in for some sticker shock, expanded subsidies that helped enroll leaves pay for the insurance are set to expire at the end of the year, 50 million Americans are insured through ACA plans, including more than half a million Illinois residents who are likely to see nearly 80% increase in their monthly premiums and some may lose coverage completely.

Joining us now are and Gillespie director of the Illinois Department of Insurance and Morgan Winters.

Director of Get Covered Illinois, the official health insurance marketplace for Illinois residents.

Welcome back.

Thanks again for talking to us about this.

And let's be let's start with the government shutdown.

Biggest reason for his due to the expansion of the subsidies for the Affordable Care Act that Democrats are holding out for up 550,000 Illinois residents have Affordable Care Act Exchange plans, which is over 90 over 91% of them benefit from these expanded subsidies and what's at risk if the subsidies expire.

>> Well, we're gonna see significant increases in premiums and they're going to hit her dust in our southern rural part of the state.

Some folks down there are going to see premiums go from 400 a month to over 1000 a month.

And we're going to see some individuals, I think roughly 30,000 the kind of losing coverage completely because they qualified under the extended tax credit and they're cutting part off completely.

>> Morgan get covered.

Illinois is the state run marketplace for the Affordable Care Act.

Its goal is to be inaccessible platform for residents.

What people need to know for the upcoming open enrollment period.

>> Open enrollment starts on November.

First at the time where all state residents and come to the marketplace and compare plans that are available to them.

Take advantage of that.

The subsidies, the premium tax credits and cost sharing reductions that they may qualify and get help picking a plan.

And that is particularly important this year when so much is changing what we are as we really are one-stop shop for folks understand their options and pick a plan that that works for them.

When costs are going up, it's particularly important to compare the available options and make sure you're making a good choice for you and your family.

>> And how's the government shutdown affecting ACA enrollment?

>> Well, we expect that their the shutdown itself isn't because the beauty of being a state-based marketplace that we converted to this year is that we're not tied into the federal operational aspects of it.

So it allows us to continue to operate.

It allows us to things like have special enrollment periods for women who are pregnant, for example, find out they're pregnant during the benefit year.

They're going to be able to enroll in coverage of that waiting until the next open enrollment period.

We're going to have provisions the income tax returns this year.

They're going allow people to check a box to get access to insurance coverage, to indicate their interest in it.

These are things that we wouldn't able to do on the federal platform and that might be impacted by the shutdown.

But because the Governor Pritzker chose to stay patient marketplace this year, we're going to be able to provide the services.

>> So okay, as you mentioned and several counties across Illinois are going to experience significant increases in their monthly premiums, rural communities in Illinois seem to be taking the biggest hit with monthly costs, skyrocketing for Effingham County at 456%, which means $1209 $1200 monthly payment per household Jackson County seeing a 274% increase.

That means a $458 monthly payment.

And of course, it is worth noting that the most populous counties in Illinois, so Cook County will be seeing a 95% increase 83% and will county.

That just means a few.

Obviously you can see on the screen the impact on the collar counties as well.

why?

>> For those downstate counties, those rural counties was such a massive increase for them.

>> There is a combination of things happening in southern Illinois and a lot of rural communities across the country.

Some of that has to do with provider rates and cuts to Medicaid are making that more expensive for states to administer.

And so that's going to drive up costs for everybody on.

There's also less care to be had in rural communities as more concentration and in metro areas, which brings down the cost for metro areas relative to 2 to rural areas.

There's also income differences that play into the amount of subsidies that are available to folks and those income differences between rural communities and and and metro communities play a factor into what folks qualify for.

>> And I imagine that, for example, folks in Effingham County and even folks in Cook County, right?

And 95% increase.

This means some people are probably just not going to be able to pay it.

But does that mean if they lose that insurance?

>> Well, that's what we're very concerned about.

We don't want people to walk away because the risk of going without insurance is, you know, is great.

You could you never know when something's going to happen.

We're going to get sick.

You might have an accident.

We're going need some coverage to help you get through very expensive medical procedures.

So we're strongly encouraging people don't give up.

When you see the premium increase.

We've got over 1500 licensed brokers available.

We've got have a gator programs across the state.

These are trained professionals who are going to help you find a plan that works for you out of the 1100 plans.

They're being offered on the exchange.

So there's probably a plan that is going to work for you for your health care needs and for your budget.

We want to be there to help.

We encourage you reach out.

>> Also and tell me a little bit about how this impacts people who are not on an ACA plan, people who may have insurance as an employee benefit.

>> Yeah.

important thing to remember is it's more than just the tax credits.

It's the impact of several things in the Trump administration and the nature won.

The Medicaid cuts are going to result in hospitals and providers losing significant revenue streams and the banks that finance them know the revenue being cut.

So they're going to be facing increasing financial pressures, which is going be place they can recover.

That is in the commercial market.

So they will be trying to reduce the rates and a commercial setting, which will increase prices for employer-based plans as well.

The tariffs are having big impacts on pharmaceuticals across the country across the country we're seeing here are hers and commercial as well as ACA raising rates by 3, 4%, solely because of the pharmaceutical tariffs.

And then just the cost of inflation under the Trump administration is driving those costs up too.

So it's the combination package of the tax credits.

The implication, the decisions under HR one and the rule that's that's taking coverage away from certain curbs tightening up or as a result and the tariffs that are really going to have impacts on health care.

Ripple effects throughout the economy.

>> Morgan, the cost of insurance they can be obviously an obstacle.

Sometimes people choose not to get covered at all.

What resources might be available for Illinois residents to get that reliable and affordable insurance.

>> important thing to remember is that all the plans on get covered.

Illinois dot offer all 10 essential health benefits.

And so that that includes preventative care that that guards folks against major illness helps prevent folks from falling into medical debt.

So health insurance is really, really important.

And even when prices go up like they are going to do this year, it's important that folks are able to review those options as and said we have a robust network of insurance brokers that partner with get covered, Illinois.

That can help folks find the plan that's right for them.

And in some cases that will mean going from a more robust cost sharing plan like bold plan to a lower meta level.

A plan that has more affordable premiums and that's okay.

>> Sorry, to cut you off.

I was just going to say it sounds like that's information.

Folks can probably get when they head to the get Covered.

Illinois website.

You make.

That's Looking for job or to Illinois.

OK?

All right.

That's where we'll have to leave it up.

My thanks to you