Illinois House committee approves Pritzker's monumental health insurance reform plan

SPRINGFIELD, Ill. (WAND) — The Illinois House Human Services Committee approved a massive plan Thursday morning to tackle predatory health insurance practices. Sponsors and advocates believe the bill can help Illinois prioritize consumers over the profits of insurance companies.

The proposal would make Illinois the first state in the country to ban prior authorization for in-patient adult and children's mental healthcare. Sponsors said the Healthcare Protection Act could also ban step therapy, the tactic insurers use to force people to receive less effective drug treatments before moving to options initially recommended by doctors.

"It bans the issuance of junk insurance or short-term insurance plans that are often very high cost of deductibles but cover very little or are misleading in the coverage that they provide," said Rep. Anna Moeller (D-Elgin).

The legislation could also crack down on ghost networks by forcing insurance companies to follow strict network adequacy and transparency standards. House Bill 5395 states that insurers would need to complete internal audits every 90 days to ensure their directories reflect the healthcare available to patients in those networks. 

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Moeller explained the Illinois Department of Insurance would also be required to approve any rate hikes on consumers and prevent premiums from being out of line with the actual cost of providing coverage.

"It's not just making sure that rates aren't too high," said Emily Miller, Senior Policy and Legislative Affairs Advisor for the Pritzker administration. "It's also making sure that rates aren't too low. You don't want to have a situation where an insurer goes under and then people don't have the coverage that they signed up for. So, that is also a reason to do it."

House Bill 5395 passed out of the House Human Services Committee on a partisan 6-3 vote. Although, Moeller and the Pritzker administration plan to file an amendment after more negotiations with the insurance industry.

The Illinois Life & Health Insurance Council currently opposes the bill language. While President Laura Minzer said she appreciated that Moeller and Miller will continue to negotiate changes, she stressed that the plan could lead to higher insurance costs and reduced access to medical care. 

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