Sweeping Illinois health insurance reforms advancing

Pritzker first outlined the proposal in his State of the State address in February, insisting it would "save lives and lower health care costs for millions of Illinoisans."

The proposals are contained in House Bill 5395, dubbed the Health Care Protection Act.

Among its significant elements are a ban on requirements for prior authorization from an insurance company before a patient can receive in-patient treatment at a mental health facility, and a ban on the use of "step therapy" in prescription drug coverage.

Step therapy, sometimes referred to as "fail first" therapy, refers to the practice of requiring patients to show that cheaper, alternative medicines or treatments are ineffective before they can be authorized to receive the drug or therapy prescribed by their doctor.

Other elements of the bill include a ban on the sale of short-term, limited duration insurance policies that don't meet minimum standards under the federal Affordable Care Act; a requirement that insurance companies use "generally accepted standards of care" in their utilization review programs; and a requirement that insurers maintain up-to-date lists of in-network providers.

The bill also authorizes the Illinois Department of Insurance to approve or reject proposed rate changes in large-group insurance plans.

Pritzker has said he expects stiff opposition from the insurance industry. But bill sponsor Rep. Anna Moeller, D-Elgin, said she and other advocates have been working with the industry to develop language that would enable companies to implement the changes.

The bill passed out of the House Human Services Committee with a technical amendment on a partisan 6-3 vote.

Moeller said she intends to bring forth an additional amendment before the bill is voted on by the full House.

Vaping measures

Two bills that would limit the marketing and sale of e-cigarettes and other vaping devices are also awaiting action in the Illinois Senate after clearing committee.

Senate Bill 2662, by Sen. Julie Morrison, D-Lake Forest, would prohibit the advertising, marketing and promoting of vaping devices that could be mistaken as innocuous objects, like school supplies.

During a news conference, sponsors specifically noted the measure was aimed at products designed to resemble items such as highlighters.

Senate Bill 3098, sponsored by Sen. Meg Loughran Cappel, D-Shorewood, would ban the sale of e-cigarettes through the internet to those under age 21.