Ill. Gov. Pritzker Signs Consumer Protection Bills for Health Insurance Coverage

CHICAGO, Illinois, May 27 -- Gov. JB Pritzker, D-Illinois, issued the following news release on May 26, 2022:

Governor Pritzker today signed HB4703, SB3910, and HB0836 into law to increase protections and access for Illinois health insurance consumers. These bills help implement fair and transparent billing practices and provide better access to information about enrollment options.

Specifically, HB4703 addresses surprise medical billing, which is one of the most common reasons people file health insurance complaints. The new law grants the Illinois Department of Insurance (IDOI) additional authority to assist consumers facing astronomical bills because they unknowingly or mistakenly received care from hospitals or doctors that were out-of-network.

"Healthcare is a right-not a privilege, and surprise medical billing further deters Illinoisans from getting the care they need," said Governor JB Pritzker. "Since day one, my administration has worked to expand access to quality, affordable healthcare. We capped the price of insulin, reduced the Medicaid backlog, and enacted the Health Care Affordability Act. I am proud to sign these bills into law to further that crucial work and ensure consumers are protected in the medical billing process."

The signed bills include:

* HB4703 - Amends the Illinois Insurance Code and addresses surprise medical billing by building on the federal No Surprises Act. The new law grants the Illinois Department of Insurance additional authority to assist consumers who were billed at out-of-network rates after unknowingly or mistakenly receiving care from hospitals, doctors and other providers that they believed were in-network.

* SB3910 - Creates a disclosure requirement on health insurance and HMO member ID cards that easily identifies the regulatory entity that holds authority over the plan, any deductible or out-of-pocket maximum applicable to the plan, as well as a phone number or website a cardholder may go to for additional plan information. The bill also allows the Department of Insurance to enforce the ID card transparency requirements that the federal No Surprises Act added to Section 2799A-1(e) of the Public Health Service Act.

* HB0836 - Creates the Health Insurance Coverage Premium Misalignment Study Act. The Department of Insurance will oversee a study to explore rate setting approaches that may yield a misalignment of premiums across different tiers of coverage in Illinois' individual health insurance market. The study will produce cost estimates for Illinois residents, along with the impact of the policy on health insurance affordability and access. It will examine the uninsured rates for low-income and middle-income residents with break-out data by geography, race, ethnicity, and income level.

"Research shows that more than 137 million people in this country recently experienced financial hardship because of medical bills, some of them unforeseen," said Lt. Governor Juliana Stratton. "This must change, and we are committed to creating the pathways to do so. These new laws will help countless families in Illinois by protecting consumer rights when it comes to health insurance and providing pathways to more accessible and transparent coverage."

"Consumers who are already suffering from illnesses or injuries should not be further burdened with higher costs because they are unable to find an in-network provider for emergency care, or because an insurer does not have enough in-network providers available in a particular coverage area," said IDOI Director Dana Popish Severinghaus. "We look forward to intervening on behalf of more Illinois insurance consumers to fight surprise medical billing."

"I am dedicated to finding ways to ensure health insurance is transparent and user friendly for consumers. Requiring your insurance card to provide necessary information will ensure consumers know where to turn to for help when they have issues with their insurance," said State Senator Laura Fine (D-Glenview). "In addition, with the passage of the rate study, the Department can take the necessary steps to make sure consumers are getting the lowest possible rates for their health care."

"Surprise medical bills are a growing problem for people everywhere," said State Representative Bob Morgan (D-Deerfield). "Particularly during health emergencies when people are most vulnerable. It's unthinkable that you can seek treatment, only to find out later that the provider is out-of-network and you're now responsible for paying a much higher than anticipated medical bill. We passed this important legislation to give DOI expanded powers to protect consumers beyond what the federal No Surprises Act provides. Additionally, the Premium Misalignment Study Act will allow legislators and regulators to get a clearer picture of the ways insurance rates are set and look for ways to protect consumers from unnecessarily high premiums."

"It's shameful that someone receiving medical care would experience financial hardship as a result of surprise medical billing," said State Senator Ann Gillespie (D-Arlington Heights). "This new law will provide even more protection for consumers from exorbitant out-of-pocket healthcare costs, especially at a time when many families are struggling to pay other household bills."

"The Shriver Center on Poverty Law commends the Governor, the Department of Insurance, and the General Assembly for passing this consumer-focused legislation making health care more transparent and protecting Illinois consumers from high and unexpected medical costs," said Stephani Becker, Associate Director of Healthcare Justice of the Shriver Center on Poverty Law. "The Shriver Center supports the Department of Insurance in their commitment to study whether premiums are misaligned across different tiers of coverage in the state's health insurance marketplace. The findings of this study will make health insurance more affordable for low- to middle-income Illinois residents and have a huge impact on over 300,000 Illinoisans who obtain coverage through the Marketplace."