IllinoisHB5492104th General Assembly (2025–2026)HouseWALLET

PRESCRIPTION HORMONE THERAPY

Sponsored By: Sponsor information unavailable

Signed by Governor

Summary

Amends the Illinois Insurance Code. Sets forth provisions requiring an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2028 to provide coverage for up to a 12-month supply of prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within the provider's scope of practice and dispensed at one time for an enrollee by a provider or pharmacist, or at a location licensed or otherwise authorized to dispense drugs or supplies. Amends the Pharmacy Practice Act. Provides that, notwithstanding any other provision of law, a dispensing provider or pharmacist shall dispense, at a patient's request, up to a 12-month supply of a prescription hormone therapy and the necessary supplies for self-administration pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, except as specified. Amends the State Employees Group Insurance Act of 1971 and the Illinois Public Aid Code to require coverage under the provisions of those Acts.

insuranceassignmentsexecutive

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 0 benefits, 0 costs, 2 mixed.

Hormone coverage for Medicaid members

Illinois Medical Assistance must provide the coverage required by the cited state laws. For qualifying hormone therapy, this includes up to a six-month supply and needed self-administration supplies beginning January 1, 2028. GLP-1 drugs are excluded, and controlled medicines are limited to the amount allowed by state and federal law.

Six-month hormone coverage for plan members

Beginning January 1, 2028, covered Illinois health plans must cover up to a six-month supply of qualifying hormone therapy and needed supplies dispensed at one time. The rule applies to individual and group plans, including covered employee plans; HMOs and health services plan corporations must follow it too. Limited health plans follow the rule only for services they already cover. GLP-1 drugs are excluded, and controlled medicines are limited by state and federal law. Plans may use lawful drug controls and limit final-quarter refills when a six-month supply was already dispensed that plan year; providers do not have to prescribe six months at once.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

  • Ann M. Williams

    Democratic • House

  • Barbara Hernandez

    Democratic • House

  • Camille Y. Lilly

    Democratic • House

  • Celina Villanueva

    Democratic • Senate

  • Dagmara Avelar

    Democratic • House

  • Daniel Didech

    Democratic • House

  • David Koehler

    Democratic • Senate

  • Edgar González, Jr.

    Democratic • House

  • Emil Jones, III

    Democratic • Senate

  • Eva-Dina Delgado

    Democratic • House

  • Jaime M. Andrade, Jr.

    Democratic • House

  • Joyce Mason

    Democratic • House

  • Justin Cochran

    Democratic • House

  • Karina Villa

    Democratic • Senate

  • Katie Stuart

    Democratic • House

  • Kelly M. Cassidy

    Democratic • House

  • Lakesia Collins

    Democratic • Senate

  • Laura Fine

    Democratic • Senate

  • Mary Edly-Allen

    Democratic • Senate

  • Maura Hirschauer

    Democratic • House

  • Mike Simmons

    Democratic • Senate

  • Natalie A. Manley

    Democratic • House

  • Rachel Ventura

    Democratic • Senate

  • Ram Villivalam

    Democratic • Senate

  • Robert Peters

    Democratic • Senate

  • Sara Feigenholtz

    Democratic • Senate

  • Sharon Chung

    Democratic • House

  • Suzanne M. Ness

    Democratic • House

  • Theresa Mah

    Democratic • House

  • Yolonda Morris

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 227 • No: 111

House vote • 6/1/2026

Senate Floor Amendment No. 2 House Concurs

Yes: 75 • No: 39

House vote • 5/31/2026

Senate Floor Amendment No. 2 Motion to Concur Recommends Be Adopted Insurance Committee;

Yes: 10 • No: 6

Senate vote • 5/30/2026

Third Reading - Passed;

Yes: 38 • No: 19

Senate vote • 5/27/2026

Do Pass Executive;

Yes: 12 • No: 1

House vote • 4/15/2026

Third Reading - Standard Debate - Passed

Yes: 74 • No: 37

House vote • 4/8/2026

House Floor Amendment No. 1 Recommends Be Adopted Insurance Committee;

Yes: 9 • No: 5

House vote • 3/18/2026

Do Pass / Short Debate Insurance Committee;

Yes: 9 • No: 4

Bill Text

  • Engrossed

  • Enrolled

  • House Amendment 1

  • Introduced

  • Senate Amendment 1

  • Senate Amendment 2

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