Illinois 2025-2026 Regular Session

Illinois Senate Bill SB0175

Introduced
1/17/25  
Refer
1/17/25  
Refer
1/28/25  
Report Pass
2/5/25  
Engrossed
4/9/25  

Caption

INS CD-KLINEFELTER SYNDROME

Impact

The legislation is expected to have a significant impact on the regulatory landscape for health maintenance organizations in Illinois. It reinforces the importance of prior health standards and ensures that HMOs must meet specific regulatory requirements set forth in existing law. This amendment strengthens protections for both current and future employees, ensuring that vital health services are included as standard offerings in health care plans. As a result, HMO compliance will be closely monitored to uphold these standards, which may lead to improved coverage and benefits for employees under state health plans.

Summary

SB0175 amends the Illinois Insurance Code and the State Employees Group Insurance Act to enhance the required health benefits for employees, particularly focusing on ensuring the inclusion of post-mastectomy care benefits. The bill mandates that health maintenance organizations (HMOs) provide coverage compliant with specific sections of the Illinois Insurance Code that dictate the necessary health service offerings. By emphasizing necessary health care provisions, the bill aims to protect employees from inadequate coverage, particularly in critical post-operative care scenarios for breast cancer survivors.

Sentiment

The sentiment surrounding SB0175 appears largely positive among advocacy groups and employees who would benefit from improved health insurance coverage. Proponents argue this measure will enhance patient care and rights, especially for those undergoing significant medical procedures such as mastectomies. However, there are concerns voiced by some stakeholders regarding the potential increased administrative and financial burden on health maintenance organizations, which could result in higher premiums for consumers.

Contention

Notable points of contention include the financial implications for HMOs and potential pushback regarding the feasibility of enforcing compliance with the new requirements. Some critics believe that imposing stricter coverage mandates could disincentivize certain insurers from participating in the state’s marketplace, thereby limiting choice for consumers. The debate centers around balancing comprehensive health care access while maintaining a healthy competition and affordability within the insurance market.

Companion Bills

No companion bills found.

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