Hundreds of new laws will hit the books in Illinois on New Year’s Day, and more than a dozen could have impacts on the health and well-being of residents.
The most far-reaching of the new laws is the Healthcare Protection Act, which was signed by Illinois Gov. J.B. Pritzker in July.
That bill took a series of steps to regulate the health insurance policies offered to Illinoisans, including banning “step therapy,” a process that required patients to try lower-cost drugs before “stepping up” to a more expensive treatment, according to GoodRx.
The legislation also eliminated prior authorization requirements for in-patient mental health care, required more transparency about prior authorization when advertising insurance coverage, and banned the sale of “junk insurance plans” that don’t comply with the provisions of the federal Affordable Care Act.
Illinois lawmakers also passed several bills that set price limits on life-saving medications and treatments. HB 3639 requires insurance companies to limit the price of a two-pack of epinephrine injectors to $60 or less, while SB 3203 requires insurance companies to cover life-saving inhalers while establishing a maximum price of $25 for a 30-day supply.
Insurance plans in Illinois will also be required to cover specific treatments, including genetic cancer screening and testing for high-risk patients (SB 2697).
Here is a rundown of other insurance-related laws hitting the books in Illinois in 2025:
Local
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.
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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 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 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 2744 – Requires insurance companies to cover vaccine administration fees, regardless of the type of provider administering the vaccine, without copay or deductible.
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.
