Insurers want to raise rates by up to 43 percent for Illinois customers who receive health care coverage under the Affordable Care Act.

Among the companies seeking double-digit rate hikes on most of their plans starting next year are the three insurers that offered Obamacare coverage in Cook County this year, according to rate reviews released by the federal government on Tuesday.

More than 351,000 Illinois residents are enrolled in Obamacare, with most of them — nearly 310,000 — covered by Blue Cross Blue Shield of Illinois.

The company is anticipating rate increases averaging 38.2 percent on its BlueCare Direct plans; 14.5 percent on its Blue Precision plans; 9.3 percent on its Blue FocusCare plans, and 5.4 percent on its Blue Choice Preferred PPO plans.

Cigna HealthCare wants a 37.7 percent increase, which would affect nearly 27,000 Illinoisans, and Celtic Insurance, the third Cook County Obamacare insurer, plans to raise rates by about 15 percent for its more than 36,000 enrollees.

Health Alliance Medical Plans, which offers Obamacare plans in central and downstate Illinois, has proposed a whopping 43.1 percent rate hike.

In the rate reviews, most companies pointed to rising costs for medical services and prescription drugs as the cause of surging rates.

Also apparently factoring into the rate hikes is the precarious state of the health care system under the Trump administration. Blue Cross Blue Shield cited “a loosening on the enforcement of the individual mandate,” while Cigna highlighted doubt as to whether the federal government will keep providing subsidies to insurers that lower copayments for low-income customers.

Insurers can change their proposed increases before they go into effect on Jan. 1, 2018. State officials can recommend changes to the companies’ proposals, but they don’t have the power to alter or reject them.