Will Illinoisans Eligible for Health Insurance Be Missed?

Illinois Eligible Uninsured

Prior to implementation of the ACA, nearly 1 out of every 7 working age adults in Illinois – about 1.7 million residents – lacked health insurance, despite the fact that the majority of them were working full time. Nearly a million Illinois residents have gained health insurance since the ACA opened for business in October 2013. But the vast majority of them got coverage through the expanded Medicaid program. That expansion brought coverage to almost 623,000 state residents.

By contrast, little more than a third of those eligible for coverage through the new Health Insurance Marketplace have signed up. With just 37% of the Marketplace-eligible population enrolled, Illinois ranks 20th out of the 37 states that operate their marketplaces using the federal HealthCare.gov website.

This means that close to two-thirds of Illinoisí Marketplace-eligible population still remains uninsured – a total of some 600,000 people.

The Open Enrollment period for 2016 coverage – November 1, 2015, to January 31, 2016 – will be a renewed opportunity to connect them to coverage and bring Illinois closer to ensuring healthcare for all. But it comes at a time when the stateís resources – and the publicís founts of attention – are at a nearly all-time low.

With the budget for Get Covered Illinois – the State's official Marketplace – drastically reduced, we need "all hands on deck" to make sure all that Illinois residents are able to get the coverage that the ACA makes available to them. Other states have found these steps are key to getting people successfully enrolled :

Illinois' Pockets of Uninsured

Ten areas of the state together account for over 100,000 eligible uninsured – one-sixth of the state's total. Five of them fall within the city of Chicago, and two in suburban Cook County – although the single largest concentration of eligible uninsured is found downstate. Overall, about 73% of the 600,000 eligible but still uninsured live and work in the Chicago metro area. More than 100,000 of them reside in areas where English is not the predominant language. Almost half of them are eligible for a tax credit or subsidy.

Champaign-Urbana. The single largest pocket of uninsured is in Champaign County, where one in every 10 residents is uninsured. It had more than 16,000 Marketplace-eligible individuals last year, fewer than a quarter of whom found coverage by the end of the last enrollment period. As a college town – the home of the University of Illinois – it will also have a disproportionate number of individuals losing coverage as they reach their their 26th birthday and can no longer be covered on their parents' plan; the so-called #BornIn89 cohort. Census tract data from prior years suggests that a pocket of uninsurance exists in the town of Rantoul. See map

McHenry Southeastern McHenry County, including the town of McHeny, also had more than 16,000 Marketplace-eligible individuals last year. Despite a signup rate close to the state average, at 35%, more than 10,500 are estimated to still lack health insurance. With substantial manufacturing and health care employment, the area has seen rapid urbanization in recent years. Prior to the ACA, a central census tract in the town of McHenry had close to 17% total uninsured. See map

Kane County Aurora Township in southeastern Kane County, where the signup rate was only 22%, alone represent almost 10,000 Marketplace eligible residents who are estimated to still be uninsured. Although boasting higher signups at 31%, the area surrounding Elgin represents another 8,600 elible residents. These figures reflect the persistence of dense pockets of uninsurance in Elgin, suggesting that concerted outreach may be required to connect these populations to coverage. See map

Cook County Cook County, with its dense urban core and extreme ethnic and economic diversity, has been found it to have the third-largest uninsurd population in the nation, after Los Angeles and Harris County, Texas. Half the nationís uninsured live in just 116 counties (Washington Post). Even excluding the undocumented, and the city of Chicago, Cook County contains some concentrated pockets of eligible uninsured. Cicero, Berwyn and Oak Park townships to the west and Niles and Evanston townships to the north are both areas associated with affluence and a large number of professionals among the residents. Yet each is also home to 10,000 uninsured people who are eligible for the Marketplace. See maps: Cicero-Berwyn-Oak Park and metro area

Chicago Eligible Uninsured

Chicago Five of the state's 10 areas of highest concentrations of eligible uninsured are within the city, each representing about 10,000. Significant proportions of the population in these areas do not speak English as their primary language. In nearly half of them, at least a third speak Spanish or another non-English language; in some, it is as high as 50% of resident. The Illinois PUMA with the highest proportion of non-English speakers, at 72%, is in southwest Chicago; it is also the one with the lowest share of eligible population enrolled in the entire state, just 21%. See maps: Northwest Chicago, Southwest Chicago and entire city

Other target areas While these brief summaries focus on some of the areas with the greatest concentrations urgently in need of health insurance outreach and assistance, other mid-sized concentrations exist, and deserve the attention of local resources. Will, McLean and Tazewell Counties all had rates of ACA signups under 30%, and taken together represent some 15,500 Marketplace-eligibile uninsured individuals. And Lake County, although the 31st wealthiest county in America, had at the start of the ACA era about 13% of its residents without health insurance, particularly in the northern part of the county. Pre-ACA census tract data also showed pockets of uninsurance in Aurora, Joliet and Kankakee. See state map

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Enrollment Target Areas in ILLINOIS
PUMA IDGeographic AreaRate Remaining
2100Champaign County - Champaign & Urbana Cities23%12,537
3527Chicago City (Southwest) - Gage Park, Garfield Ridge & West Lawn21%10,976
3602McHenry County (Southeast) - Algonquin, McHenry & Nunda Townships35%10,625
3521Chicago City (West) - Austin, Belmont Cragin & Montclare30%10,399
3526Chicago City (Southwest) - Brighton Park, New City, Bridgeport & McKinley Park29%10,288
3408Cook County (Central) - Cicero, Berwyn & Oak Park Townships32%10,114
3504Chicago City (Northwest) - Irving Park, Albany Park, Forest Glen & North Park36%10,056
3421Cook County (North) - Niles & Evanston Townships43%9,987
3524Chicago City (West) - West Town, Near West Side & Lower West Side38%9,902
3005Kane County (Southeast) - Aurora Township22%9,683
 
 
Enrollment Target Areas in CHICAGO
PUMA IDGeographic AreaRateRemaining
3527Chicago City (Southwest) - Gage Park, Garfield Ridge & West Lawn21%10,976
3521Chicago City (West) - Austin, Belmont Cragin & Montclare30%10,399
3526Chicago City (Southwest) - Brighton Park, New City, Bridgeport & McKinley Park29%10,288
3504Chicago City (Northwest) - Irving Park, Albany Park, Forest Glen & North Park36%10,056
3524Chicago City (West) - West Town, Near West Side & Lower West Side38%9,902
3520Chicago City (Northwest) - Portage Park, Dunning & Jefferson Park36%9,254
3503Chicago City (North) - West Ridge, Lincoln Square & North Center41%8,881
3530Chicago City (South) - Ashburn, Washington Heights, Morgan Park & Beverly23%8,424
3523Chicago City (West) - North & South Lawndale, Humboldt Park, East & West Garfield Park 32%7,857


Uninsured residents have historically been unevenly distributed across the state, reflecting varying patterns of income, employment and ethnic heritage. Similarly, the success of ACA enrollment efforts thus far have varied widely, reflecting the different degrees of ease of reaching and informing people. The 10 areas with the highest enrollment rates collectively succeeded in covering 47,000 individuals, or 48% of those eligible. By contrast, the bottom 10 together enrolled fewer than 30,000, only 25%. These data were put together by the Kaiser Family Foundation, by aggreating federal enrollment and demographic data into geographic areas called PUMAs, which are used by the federal government. See KFF's original analysis