Illinois Senate Insurance Committee approves Healthcare Protection Act

SPRINGFIELD, Ill. (WAND) — The Illinois Senate Insurance Committee approved a massive bill Tuesday night to help curb predatory insurance practices and protect consumers.

The Healthcare Protection Act would make Illinois the first state to ban prior authorization for in-patient adult and children's mental healthcare.

This plan could also ban step therapy, or the fail first method, where insurers force people to receive less effective drug treatments before moving to options initially recommended by doctors.

"If it's on the formulary, it's just making sure that we recommend the best treatment," said Sen. Robert Peters (D-Chicago). "I can tell you as someone who visits my doctor, I hope and believe, I think we all do, that our doctor is going to recommend the best treatment. That's the reason we go to our doctors."

The measure would also require prior approval from the Department of Insurance before large group insurance plans can increase rates and require premiums to align with the actual cost of providing care.

Republicans stressed that they are concerned this plan will lead to higher insurance premiums for most Illinoisans.

"Affordability is becoming a huge problem for individuals," said Sen. Dave Syverson (R-Cherry Valley). "Over 1 million have dropped their coverage in Illinois. 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."

This plan could also crack down on ghost networks by forcing insurance companies to follow strict network adequacy and transparency standards. The bill 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.

House Bill 5395 passed out of the Senate Insurance Committee on a 7-4 vote. It now moves to the Senate floor for further consideration.

The Senate Insurance Committee also approved a bill to ban short-term limited duration insurance plans. Sen. Laura Fine (D-Glenview) and experts from the Illinois Department of Insurance explained the plans, commonly referred to as junk insurance, fail to cover basic treatments like maternal healthcare and pre-existing conditions.

House Bill 2499 received a 7-4 vote in the Senate Insurance Committee and now moves to the Senate floor for further consideration.