Gov. J.B. Pritzker on Wednesday signed legislation advocates say will do away with health insurance practices that make it harder for patients to receive needed care.
“For too long, insurance companies have used predatory tactics to make an extra dime at the expense of Illinois consumers. … For too long, shoddy networks, price gouging and overly complicated bureaucracies have stood in the way of our families getting the care that they deserve,” Pritzker said at a West Side signing ceremony. “Today, with my signature, Illinois is addressing and rectifying that.”
The legislation, which passed by wide margins and with bipartisan support in the General Assembly this spring, marks a key policy victory for Pritzker, who promised in February to put his “shoulder to the wheel” to pass health care reform.
The new law includes a prohibition on insurance plans requiring what is known as “step therapy,” which is when the insurer requires a customer to try different treatments or medications before those prescribed by their doctor. Doctors and patient advocates say the practice can worsen patients’ conditions, while the insurance industry argues it keeps costs down.
The law also prohibits insurers from requiring prior authorization, cases where patients need permission from insurance companies before receiving treatment for in-patient, or overnight, mental health care at a hospital. In addition, it bans the sale of short-term, limited-duration health insurance plans, which don’t cover as many medical services as typical plans, and allows the state’s Department of Insurance to reject unreasonable price increases proposed by certain large group health insurance policies.
Marilyn Zydlo, an advocate for the bill whose son Jimmy was diagnosed with Stage 3 advanced Hodgkin’s lymphoma at 17, said at Wednesday’s event that the law would have helped when Jimmy needed certain antibiotics while undergoing treatment.
“We wouldn’t have had to fight with the insurance companies to get the initial prescription,” she said. Jimmy’s cancer is now in remission, she said.
Parts of the law will begin to take effect in January while others won’t go into effect until 2026.
The health insurance bill is the latest agenda item pushed by the Pritzker administration during the spring legislative session that the governor has recently signed into law. Others include a measure aimed at erasing as much as $1 billion in medical debt for more than 300,000 Illinois families; the creation of a new Department of Early Childhood; and authorization for incentives to boost Illinois’ standing in the quantum computing field.
