In Review: Last week, Governor J. B. Pritzker (D) addressed the Illinois House and Senate with his State of the State and budget speech. The Governor announced plans to introduce the Healthcare Consumer Access and Protection Act. This ambitious act seeks to ban prior authorization for in-patient mental healthcare and step therapy, tackle “ghost networks,” expand prior approval for large group health insurance rates, and eliminate short-term limited-duration plans. He committed to using significant political capital to pass this bill. While he did not specifically mention PBMs, he allocated eight minutes to health plan reforms, particularly emphasizing the need to address issues like prior authorization, utilization review, and step therapy. Despite not directly mentioning PBMs, these proposed reforms will inevitably affect our industry. We are preparing to work closely with the Health Plan Association of Illinois on this matter. In addition to addressing health care issues, the nearly one-hour speech took a politically charged stance where Gov. Pritzker criticized Texas Governor Greg Abbott (R) for creating a “political stunt” by sending migrants to Chicago, likened Donald Trump to the Ku Klux Klan, and contrasted California Governor Gavin Newsom’s (D) budget deficit with his own balanced budget. Indicating possible presidential aspirations within the Democratic Party, the Governor’s criticism of health insurance companies for engaging in “predatory practices that block patient access to needed care” was clearly meant to gain political favor with the electorate. Additionally, PCMA has developed alternative language for SB 3179 to provide to Senator Harris, continuing the open dialogue on his legislation.

Up Next: The legislature will not hold committee meetings this week.

If you have any questions, please contact Melodie Shrader at mshrader@pcmanet.org.