More than 92,000 Illinois consumers lost or dropped their Affordable Care Act health insurance in recent months — an unusually large number — following the expiration of generous tax credits that had helped to curb the plans’ costs. 

Initially, 448,568 Illinois residents enrolled in health insurance plans sold on the state’s exchange, Get Covered Illinois, during the state’s open enrollment window, which ran from Nov. 1 through Jan. 31. But in the months that followed — when many consumers started receiving their new, higher bills — 92,571 consumers disenrolled, according to data from Get Covered Illinois.

Morgan Winters, director of Get Covered Illinois, said it’s the “largest drop we’ve seen in the state for almost a decade, so that is certainly alarming,” during a meeting Monday of the Illinois Health Benefits Exchange Advisory Committee. 

Some people always drop their coverage after open enrollment, but this year the disenrollment rates were two to three times higher than at any time in the last six years, Winters said.

Overall, about 15% fewer Illinois consumers now have exchange plans compared with the number who had them in February of last year after paying their first premiums following open enrollment, according to KFF, a nonprofit organization focused on health policy.

“This is a pretty significant drop in insurance, which is going to translate into a higher uninsured rate in the state and across the country,” Winters said.

Of the 92,571 people who dropped or lost their coverage in recent months, about 64% lost it because they didn’t pay their monthly premiums, and about 28% actively canceled their insurance plans, with some of those people saying they’d found coverage elsewhere and others citing affordability, Winters said. 

Many of the people who initially enrolled in coverage were people who had it last year and were automatically re-enrolled, meaning it’s possible they didn’t realize how much more expensive their same coverage would be this year until bills started hitting their mailboxes. 

This year, Illinois consumers who bought health insurance on the state’s Affordable Care Act exchange are paying 26% more for coverage on average than they did last year, according to data previously released by Get Covered Illinois.

Illinois consumers with exchange plans are paying average monthly premiums of $328 per household for coverage this year, compared with $260 last year, Get Covered Illinois reported earlier this year.

The costs went up this year, in large part, because of the expiration of more generous tax credits that were put in place during the pandemic. Those tax credits have long helped reduce the monthly prices, called premiums, of health insurance. During the pandemic, the credits were expanded to be larger and include more people.

Congress, however, failed last year to reach a deal to extend those more generous credits — an issue that was at the heart of the government shutdown last year.

As a result, though many people are still receiving tax credits this year, they’re not as large as they have been, and not as many consumers are eligible for them. 

It’s not surprising that many people lost or dropped their exchange plans, given the higher costs of insurance, the expiration of the enhanced subsidies and that other types of goods have also become more expensive, said Stephanie Altman, counsel with the Legal Council for Health Justice.

“It was kind of a perfect storm that we knew we were going to lose a lot of people,” said Altman, who is also a member of the Illinois Health Benefits Exchange Advisory Committee.

Still, she said she was pleased to see Illinois did as much as it could to mitigate the price increases this year. 

Get Covered Illinois implemented a new strategy this year that made gold plans more affordable, in some cases, than silver plans. Movement out of more expensive silver plans to gold and bronze plans helped reduce the average price increase for many households.

Get Covered Illinois also held a public awareness campaign about the importance of actively shopping for the best value plans as opposed to letting plans renew automatically.

Though 92,571 consumers disenrolled from exchange plans since open enrollment ended, another 17,068 signed up for coverage after open enrollment ended by using special enrollment periods, such as those for people who lost Medicaid or their job-based health insurance.

The drop in exchange plan enrollment in Illinois mirrors trends nationally. 

Across much of the country, about 14% of people enrolled in individual plans did not pay their first monthly premium in January, according to a report from Wakely Consulting Group. 

Wakely has estimated that overall coverage across the country for people with individual plans, rather than group ones, could drop by 17% to 26% this year compared with last year.