Health insurance procedures will look different in Illinois if legislation advancing through Springfield becomes law, but some are concerned about the cost to taxpayers.
In the latest push for health insurance reform, Gov. J.B. Pritzker is taking aim at what he calls “predatory health insurance practices” with his Healthcare Protection Act.
Among other things, the legislation would ban step therapy, the tactic insurers use to require people to receive less effective drug treatments before moving to options initially prescribed by doctors. It also includes new requirements for insurers to offer enough in-network doctors to meet patients’ needs.
The proposal would make Illinois the first state in the country to ban prior authorization for in-patient adult and children’s mental health care.
“The bill’s purpose is to make quality care easier to access for patients all across the state of Illinois and to increase accountability in insurance companies,” said Pritzker.
Pritzker plans to tour the state this week to publicize the legislation.
Additionally, the measure mandates that all insurance companies regulated by the state of Illinois disclose treatments requiring prior authorization, facilitating consumers’ ability to compare plans when seeking coverage. Short Term Limited Duration insurance plans, often called “junk insurance,” will also be barred.
The legislation’s final initiative targets the elimination of unchecked rate increases in fully insured large-group insurance carriers.
“This legislation makes sure that health plans don’t get between a patient and their doctor when they are making life altering decisions, or requires that patients try alternatives to the prescribed medication, because it’s cheaper for the insurance company,” said the bill’s sponsor, state Rep. Anna Moeller, D-Elgin.
State Rep. Ryan Spain, R-Peoria, said he is concerned about what the bill will do to insurance premiums.
“One of the estimates that I received from the insurance industry is very real concern that some of the changes in this legislation could put upward pressure on premiums, anywhere from $12 to $40 per month,” said Spain.
If it becomes law, it is estimated it could cost state taxpayers an extra $30 million a year.
The Illinois Freedom Caucus released a statement following the bill’s passage in the House.
“Only in Illinois can we pass a bill which raises insurance premiums for working families, delivers more free Cadillac healthcare for illegals, and call it a success,” the group said.
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By Kevin Bessler with the Illinois Radio Network
