Hundreds of new laws will be introduced in Illinois on New Year's Day, and more than a dozen of them could have impacts on the health and well-being of residents.
The most far-reaching of the new laws is the Health Care Protection Act, which Illinois Governor JB Pritzker signed in July.
This bill took a series of steps to regulate health insurance policies offered to Illinois residents, including banning “step therapy,” a process that requires patients to try less expensive medications before “progressing” to more expensive treatment, according to GoodRx.
The legislation also eliminated prior authorization requirements for inpatient mental health care, required greater transparency about prior authorization when advertising insurance coverage, and prohibited the sale of “junk insurance plans” that do not comply with provisions of the federal Affordable Care Act. .
Illinois lawmakers have also passed several bills that set price limits on life-saving medications and treatments. HB 3639 requires insurers to limit the price of two packs of epinephrine syringes to $60 or less, while SB 3203 requires insurers to cover life-saving inhalers with a maximum price of $25 for a 30-day supply.
Insurance plans in Illinois would also be required to cover specific treatments, including genetic cancer screening and testing for high-risk patients (SB 2697).
Here is a summary of other insurance-related laws that will be passed in Illinois in 2025:
HB 2350 – Requires Illinois companies that provide health insurance to cover annual prostate cancer screenings, Pap smears, or Pap smears for all insured individuals, regardless of sex.
HB 2443 – Requires that new insurance plans provide coverage for medically necessary hearing aids and related services to all individuals, not just those under 18 years of age.
HB 4460 – Requires insurance programs to provide coverage for mental health treatment services to police officers, members of self-insured fire protection districts, and any spouse or partner of members of those districts.
HB 5142 – Birth Equality Act provisions requiring insurance companies to cover the services of doulas and midwives will go into effect on January 1. Other provisions of the bill will not take effect until January 2026.
HB 5258 – Requires insurers to make dependent coverage available to eligible parents or stepparents of the insured if they meet the definition of “qualifying relative” under federal law.
HB 5643 – Private insurance and Medicaid are now required to cover urine-based home pregnancy tests.
SB 2195 – Requires insurers to cover an artificial or custom orthotic device that is “medically necessary for the enrollee to perform physical activities, such as running, biking, swimming, and weight lifting.”
SB 2744 – Requires insurers to cover vaccine administration fees, regardless of the type of provider administering the vaccine, with no copayment or deductible.
SB 3318 – Insurance plans for state employees would be required to cover all FDA-approved Alzheimer's disease treatments, as well as prescription medications to slow the disease.
SB 3538 – Certain insurance plans would be required to cover mental health counseling for first responders.
SB 3599 – Insurers must cover “ambulatory integrated health care services” necessary for frequent users of emergency care in hospitals.
