Health Insurance

Chicago Hispanic Newspaper, Lawndale News, Hispanic Bilingual Newspapers, Su Noticiero Bilingue » Gov. Pritzker Highlights Health Insurance Reform Initiatives

Lawndale News Chicago's Bilingual Newspaper - Health

Governor JB Pritzker joined doctors, patients, stakeholders, and legislators to highlight efforts to reform predatory health insurance practices and protect patients. The Healthcare Protection Act (HPA), first introduced in the governor’s FY25 Budget Address in late February, aims to put power back into the hands of patients by banning step therapy, banning prior authorization for crisis mental health care, improving network adequacy, and ending unchecked rate increases for large group insurance companies. HPA is targeting utilization management, which often forces consumers to obtain permission from their providers before receiving care that doctors have already determined is necessary. This increases profits for insurance companies and creates barriers to care for patients and their doctors. Utilization management also includes a practice called “step therapy,” which forces patients to move through less effective treatment options before gradually gaining access to the treatment that doctors recommended initially. HPA will ban “step therapy” processes in Illinois, and require insurance companies to align definitions of medical necessity to match those of physicians. HPA also addresses prior authorization. Illinois will soon become the first state in the nation to ban prior authorization for in-patient adult and children’s mental health care.

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