Legislators like to make people think they are providing new benefits under health insurance.
What they don’t want people to now or, perhaps, don’t know themselves, is that most people are not covered under state-regulated health insurance plans.
Most medical pans are regulated by the Federal government.
When I was in the Illinois House a couple of decades ago only about twenty percent of what people call health insurance was influenced by state law.
That having been said, here are the increased mandates on state-regulated health insurance companies, all of which will push the cost of such health insurance up:
new laws impacting health insurance in Illinois next year:
HB 2350 – Requires companies in Illinois that provide health insurance to cover annual prostate cancer screenings, cervical smears or Pap smears for all insured individuals, regardless of gender.
HB 2443 – Requires that new insurance plans must provide coverage for medically necessary hearing instruments and related services for all individuals, not just those under the age of 18.
HB 3639 – Requires insurance companies to limit the total price of a twin-pack of medically necessary epinephrine injectors to $60 or less.
HB 4460 – Requires insurance programs to provide coverage for mental health therapy services to police officers, members of self-insured fire protection districts, and any spouse or partner of members of those fields.
HB 4789 – Dental insurance companies will be prohibited from denying claims on procedures that were subject to prior authorization unless specific criteria are met.
HB 5142 – The “Birth Equity Act” provisions pertaining to requiring insurance companies to cover services of doulas and midwives will take effect on Jan. 1. Other provisions of the bill will not take effect until Jan. 2026.
HB 5258 – requires insurance companies to make dependent coverage available to qualifying parents or stepparents of the insured if they meet the definition of a “qualifying relative” under federal law.
HB 5395 – A wide-ranging medical insurance reform bill that prohibits companies from denying claims and persuading patients to opt for low-cost alternatives for treatments. It also outlaws “step therapy,” where patients have to use cheaper drugs before being approved for more expensive ones. The bill also prohibits the sale of limited-duration medical insurance coverage that doesn’t meet minimum standards established by the federal Affordable Care Act.
HB 5643 – Private insurance and Medicaid are now required to cover at-home, urine-based pregnancy tests.
SB 2195 – Requires insurance companies to cover a prosthetic or custom orthotic device that is “medically necessary for the enrollee to perform physical activities, such as running, biking, swimming and lifting weights.”
SB 2641 – Insurance companies will be required to show that each in-network hospital has at least one radiologist, pathologist, anesthesiologist and ER physician as a preferred provider.
SB 2697 – Requires insurance and Medicaid to cover genetic cancer screening and testing for high-risk patients.
SB 2744 – Requires insurance companies to cover vaccine administration fees, regardless of the type of provider administering the vaccine, without copay or deductible.
SB 3203 – Insurance companies cannot deny coverage for life-saving inhalers, and must establish a cap of $25 for a 30-day inhaler supply.
SB 3318 – Insurance plans for state employees will be required to cover all FDA-approved treatments of Alzheimer’s disease, as well as medications prescribed to slow the disease.
SB 3538 – Certain insurance plans will be required to cover mental health counseling for first responders.
SB 3599 – Insurance companies must cover necessary “mobile integrated health care services” for frequent users of emergency hospital care.
