CHICAGO (WGEM) – Major changes are coming to Illinois’ health insurance industry as Gov. JB Pritzker signed the Healthcare Protection Act into law Wednesday.
Pritzker signed two bills in a signing ceremony in Chicago. One is the main Healthcare Protection Act (HPA). The other new law bans short-term limited duration (STLD) plans, which have also been referred to as “junk” plans.
“The HPA was conceived, written and passed with the goal of empowering the two most important stakeholders in the medical system, our patients and their doctors,” Pritzker said.
The new law does several things. It bans so-called “step therapy.” This is when an insurance company requires a patient to try and fail alternative medications before covering medications their doctor recommends.
It also bans prior authorization for in-person mental health treatment for the first 72 hours. It would also require insurers post all procedures requiring prior authorization.
The HPA also ends unchecked rate increases for large group insurance companies.
“For thousands of Illinoisans, the reforms in this bill will mean the difference between suffering with curable health conditions and getting the care that they need in a timely manner, and for some, this bill will quite literally save their lives,” Pritzker said.
The STLD ban was originally part of the HPA, but the state Senate chose to pass it in a separate bill. Supporters argue these plans are exempted from and often don’t meet the minimum stands in the Affordable Care Act, and they also don’t typically cover preexisting conditions.
“Too many residents in Illinois have been tricked into buying these limited-duration plans for bridge insurance coverage only to find out they’re flying a plane without a parachute,” said state Rep. Bob Morgan, D-Deerfield.
Pritzker originally proposed the HPA during his State of the State address on Feb. 21. He believes the new laws will help ensure patients and doctors are at the center of care, not insurance companies.
“For too long, shotty networks, price gouging and overly complicated bureaucracies have stood in the way of families getting the care that they deserve. Today, with my signature, Illinois is addressing and rectifying that problem,” Pritzker said.
The main HPA bill passed with bipartisan support and the STLD ban passed along party lines.
Opponents fear the new laws could limit choices and potentially lead to rate increases.
“The concern I have is that we keep adding benefits, and they’re all good, but we keep making insurance so good that people can’t afford it any longer,” said state Sen. Dave Syverson, R-Cherry Valley, while the HPA was being debated in committee in May.
Copyright 2024 WGEM. All rights reserved.