SPRINGFIELD, Ill. (WAND) — Gov. JB Pritzker signed a historic plan into law Wednesday to crack down on predatory insurance practices and lift up consumers. The Healthcare Protection Act could make care more affordable and accessible for millions of Illinoisans.
After a lengthy negotiation process during the 2024 spring session, the Healthcare Protection Act is now law. The legislation bans step therapy, or the fail first method, so insurance companies can no longer force people to receive less effective treatment before moving to options recommended by doctors.
"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. "This bill is fundamentally about putting medical decisions back in their hands."
Gov. JB Pritzker celebrated the Healthcare Protection Act with sponsors and advocates on July 10, 2024.
Illinois is now the first state to ban prior authorization for in-patient adult and children's mental healthcare. The new law also requires prior approval from the Illinois Department of Insurance before large group insurance plans can increase rates. Premiums must align with the actual cost of providing care as well.
"It's about recognizing that healthcare is a fundamental right, not a privilege," said Rep. Anna Moeller (D-Elgin). "It's about ensuring that our healthcare system serves the needs of patients and supports the dedicated professionals who provide their care."
Many people across central Illinois will be happy to know the law also bans ghost networks by forcing insurance companies to follow strict network adequacy standards. The law states that insurers must complete internal audits every 90 days to ensure their directories reflect the care available to patients.
"We're going to ease the stress for you and your loved ones during a mental health crisis," said Sen. Robert Peters (D-Chicago). "We're going to reduce the confusion when it comes to finding a provider. Instead of the steep steps of care that existed before, we're building an elevator to the treatment you need and deserve."
Pritzker also signed legislation to ban short-term limited duration insurance plans Wednesday. Sponsors said junk insurance plans fail to cover basic treatments like maternal healthcare and pre-existing conditions.
"We're putting patients before profits," said House Speaker Emanuel "Chris" Welch (D-Hillside). "We're putting patients' healthcare before large group insurance companies. This is what it should be about."
The Healthcare Protection Act and junk insurance prohibition will take effect on January 1, 2025.
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