IllinoisHB5492104th General Assembly (2025–2026)HouseWALLET

PRESCRIPTION HORMONE THERAPY

Sponsored By: Sponsor information unavailable

Became Law

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: 1 benefits, 0 costs, 1 mixed.

Hormone therapy rule applies to more plans

The law applies the hormone therapy coverage rule to more plan types. The State Employees Group Insurance Program and employee plans under Section 10-22.3f must include it. HMOs must follow it for their enrollees. Limited health service and voluntary health services plans must follow it when the therapy is within their covered services. This lines up coverage across plans and can lower out-of-pocket costs for many enrollees.

Six-month hormone therapy refills in 2028

Beginning January 1, 2028, Illinois health plans issued, delivered, amended, or renewed must cover prescription hormone therapy and let you fill up to a 6-month supply at once, plus needed supplies for self-use. If the drug is a controlled substance, the plan allows the maximum supply state and federal law permit. If you already filled 6 months in a plan year, plans may limit refills to the last quarter of that year. Doctors are not required to prescribe 6 months at once, and plans may use allowed drug-management rules. GLP-1 drugs and GLP-1 receptor agonists are excluded from this coverage rule.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

  • Ann M. Williams

    Affiliation unavailable

  • Barbara Hernandez

    Affiliation unavailable

  • Camille Y. Lilly

    Affiliation unavailable

  • Celina Villanueva

    Affiliation unavailable

  • Dagmara Avelar

    Affiliation unavailable

  • Daniel Didech

    Affiliation unavailable

  • David Koehler

    Affiliation unavailable

  • Edgar González, Jr.

    Affiliation unavailable

  • Emil Jones, III

    Affiliation unavailable

  • Eva-Dina Delgado

    Affiliation unavailable

  • Jaime M. Andrade, Jr.

    Affiliation unavailable

  • Joyce Mason

    Affiliation unavailable

  • Justin Cochran

    Affiliation unavailable

  • Karina Villa

    Affiliation unavailable

  • Katie Stuart

    Affiliation unavailable

  • Kelly M. Cassidy

    Affiliation unavailable

  • Lakesia Collins

    Affiliation unavailable

  • Laura Fine

    Affiliation unavailable

  • Mary Edly-Allen

    Affiliation unavailable

  • Maura Hirschauer

    Affiliation unavailable

  • Mike Simmons

    Affiliation unavailable

  • Natalie A. Manley

    Affiliation unavailable

  • Rachel Ventura

    Affiliation unavailable

  • Ram Villivalam

    Affiliation unavailable

  • Robert Peters

    Affiliation unavailable

  • Sara Feigenholtz

    Affiliation unavailable

  • Sharon Chung

    Affiliation unavailable

  • Suzanne M. Ness

    Affiliation unavailable

  • Theresa Mah

    Affiliation unavailable

  • Yolonda Morris

    Affiliation unavailable

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

Actions Timeline

  1. Public Act . . . . . . . . . 104-0537

    6/29/2026House
  2. Effective Date January 1, 2027

    6/29/2026House
  3. Governor Approved

    6/29/2026House
  4. Sent to the Governor

    6/10/2026House
  5. Passed Both Houses

    6/1/2026House
  6. House Concurs

    6/1/2026House
  7. Senate Floor Amendment No. 2 House Concurs 075-039-000

    6/1/2026House
  8. Added as Alternate Co-Sponsor Sen. Mary Edly-Allen

    5/31/2026Senate
  9. Senate Floor Amendment No. 2 Motion to Concur Recommends Be Adopted Insurance Committee; 010-006-000

    5/31/2026House
  10. Senate Floor Amendment No. 2 Motion to Concur Rules Referred to Insurance Committee

    5/30/2026House
  11. Senate Floor Amendment No. 2 Motion to Concur Referred to Rules Committee

    5/30/2026House
  12. Senate Floor Amendment No. 2 Motion Filed Concur Rep. Katie Stuart

    5/30/2026House
  13. Placed on Calendar Order of Concurrence Senate Amendment(s) 2

    5/30/2026House
  14. Arrived in House

    5/30/2026House
  15. Senate Committee Amendment No. 1 Tabled Pursuant to Rule 5-4(a)

    5/30/2026Senate
  16. Third Reading - Passed; 038-019-000

    5/30/2026Senate
  17. Placed on Calendar Order of 3rd Reading

    5/30/2026Senate
  18. Senate Floor Amendment No. 2 Adopted; Collins

    5/30/2026Senate
  19. Recalled to Second Reading

    5/30/2026Senate
  20. Senate Floor Amendment No. 2 Be Approved for Consideration Assignments

    5/28/2026Senate
  21. Added as Alternate Chief Co-Sponsor Sen. Celina Villanueva

    5/28/2026Senate
  22. Placed on Calendar Order of 3rd Reading May 29, 2026

    5/28/2026Senate
  23. Second Reading

    5/28/2026Senate
  24. Senate Floor Amendment No. 2 Referred to Assignments

    5/27/2026Senate
  25. Senate Floor Amendment No. 2 Filed with Secretary by Sen. Lakesia Collins

    5/27/2026Senate

Bill Text

  • Engrossed

  • Enrolled

  • House Amendment 1

  • Introduced

  • Senate Amendment 1

  • Senate Amendment 2

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