Governor Pritzker Signs Healthcare Protection Act Into Law

CHICAGO—Today Governor JB Pritzker signed the package of bills comprising the Healthcare Protection Act (HPA) into law, a series of reforms initially proposed by the Governor in his 2024 State of the State address. The HPA works to improve healthcare consumer experiences by banning step therapy and prior authorization for crisis mental healthcare, banning junk insurance plans, and ending unchecked rate increases for large group insurance companies.

“With the signing of these bills, we’re putting power back into the hands of patients and their doctors and out of the grasps of predatory insurance companies who prioritize profits over patient outcomes,” said Governor JB Pritzker. “Accessing care shouldn’t require endless bureaucracy and navigation, especially when someone is at their most vulnerable, and this legislation will make care more affordable and accessible for millions of Illinoisans.”

“The Healthcare Protection Act unequivocally takes power out of the hands of insurance companies and places it squarely where it belongs – in the palms of the people,” said Lt. Governor Juliana Stratton. “Thank you to Governor Pritzker and our partners in the General Assembly for prioritizing the health of all Illinoisans. This is compassionate, responsible leadership at work!.”

The HPA was designed and proposed by Governor Pritzker to make healthcare more affordable and accessible for Illinois consumers and return a sense of autonomy and control to patients and doctors. The legislation was drafted based on feedback from medical professionals on what barriers to care they and their patients faced regularly.

A main target of the HPA is step therapy, the practice of insurance providers requiring patients to try and fail on often less effective treatment options and medications first before getting the care recommended by their doctor. The legislation also eliminates prior authorization requirements for in-patient mental health care, recognizing that patients in need of urgent mental health care are often not able to navigate and wait out a prior authorization process.

The HPA also requires insurance companies be transparent about prior authorization requirements when advertising coverage. Since in-network availability is often the only way patients can access care, the HPA also sets standards for appointment time availability and number of in-network doctors, ensuring that patients can actually locate care in their area and have a transparent view of their in-network providers.

In addition to utilization management regulation, the HPA also pans the sale of junk insurance plans that fail to meet Affordable Care Act standards. In 2023, the General Assembly and Governor Pritzker ended unfair rate increases for individual policy holders and the small group insurance market. The HPA extends that regulation to large group insurance carriers as well.

“Health insurance plans should be focused on improving health, not on maximizing profits,” said Senate President Don Harmon (D-Oak Park). “These two new laws will make it easier for people to access the care they need. I applaud Gov. Pritzker, Senator Peters and Senator Fine for their initiative and hard work.”

"This transformative piece of legislation puts patient care ahead of insurance profits, reins in rising costs, and will help millions of Illinoisans access the care they need when they need it," said Speaker Emanuel "Chris" Welch. "I'm proud to stand alongside Governor Pritzker, Rep. Moeller, Sen. Peters, and many others who helped champion this historic win for Illinois." 

"Insurance coverage is supposed to be there to support you in times of crisis," said Sen. Laura Fine (D-Glenview). "Unfortunately, due to a lack of transparency, many individuals and families who have had short term limited duration plans were not aware of the limited coverage that these plans offered. As a result, some went into medical debt. This legislation ensures that consumers will have the necessary coverage they need to protect them."

“The Healthcare Protection Act will make life better for patients and doctors in Illinois," said Rep. Anna Moeller (D-Elgin). "It makes significant reforms to tear down barriers that block patients from getting the healthcare that they need. I applaud Governor Pritzker for his incredible leadership, my colleagues in the General Assembly who supported HB5395 and I am grateful to the healthcare professionals and patient advocates who helped pass this legislation. They were all very clear: Illinoisans deserve better when it comes to health care access and affordability, and I’m proud to say this law will finally deliver. It’s time to put patients over corporate profits.”

"The Healthcare Protection Act reflects some of the strongest behavioral and physical health protections ever enacted in the United States. Banning junk insurance, ending step therapy and prior authorization for mental health, taking on ghost networks, and lowering health insurance rates to make healthcare more affordable will immeasurably improve healthcare in Illinois," said Rep. Bob Morgan (D-Deerfield). "Today marks a major step towards healthcare equity, and we will use this legislation as a benchmark for future efforts toward a healthier Illinois."

“These monumental pieces of legislation will move Illinois one step closer to increasing health care accessibility and affordability for all residents,” said State Senator Napoleon B. Harris, III (D-Harvey). “By increasing transparency in health care plans and ending unfair tactics by bad actors, we are providing Illinoisans with the tools to make educated decisions about their health and well-being.”

“The Healthcare Protection Act puts patients first and stops unfair insurance practices that have taken advantage of vulnerable people, leaving them with financial hardship, limited access to medical care, and increased stress,” said Sen. Robert Peters (D-Chicago). “By pushing for more fair and transparent insurance practices, Illinois is building trust in the health care system and ensuring integrity within our insurance providers.”

“The physicians of the Illinois State Medical Society appreciate Governor Pritzker’s strong support of putting more medical decisions back in the hands of patients and doctors,” said Piyush I. Vyas, M.D., President of the Illinois State Medical Society. “The health insurance reforms passed by Illinois lawmakers will ensure that administrative delays caused by insurance companies, as well as their inadequate provider networks, should be a thing of the past. Every person in Illinois deserves access to quality healthcare in their communities without long waits or interruptions for medical care and treatment.”

“Governor Pritzker is a true mental health champion,” said Bill Smith, Founder and CEO of Inseparable. “Not only does the Healthcare Protection Act improve care for the more than 2 million Illinoisans with diagnosed mental health conditions, it shows the nation what is possible when you commit to protecting patients and holding insurance companies accountable. We are proud to have supported this legislation and thrilled to see it signed into law.”

"Citizen Action/Illinois is proud to support the Health Care Protection Act, and we thank Governor J.B. Pritzker for signing it into law,” said Julie Sampson, Executive Director for Citizen Action/Illinois. “For too long, insurance companies in Illinois have used the excuse of "utilization management" to limit needed patient care from the billing office. The irony is that insurance company tactics like junk plans, prior authorization requirements and step therapy result in less effective care for Illinoisans at a higher cost. Health care decisions are best made between patients and doctors--not insurance companies. The HPA will end predatory junk plans and fail-first practices that waste precious time and money for patients seeking care."

“The Illinois Health and Hospital Association and the Illinois hospital community applaud Governor Pritzker and the legislature for enacting the Healthcare Protection Act, which will protect patients from predatory health insurance practices and eliminate barriers to healthcare for people across the state of Illinois,” said A.J. Wilhelmi, President and CEO, Illinois Health and Hospital Association. “This action is a critical step to expand continuity of care by prohibiting prior authorization for inpatient mental health services and addressing limitations on step therapy requirements, putting medical decisions back in the hands of patients and their doctors.”

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