All Roll Calls
Yes: 184 • No: 1
IllinoisSB2921104th General Assembly (2025–2026)SenateWALLET
INS-EYE MEDICATION COVERAGE
Sponsored By: Laura Fine (Democratic)
Signed by Governor
Summary
Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage for eye medication under the provisions of those Acts pursuant to the Topical Eye Medication Prescription Act.
assignmentsinsuranceprescription drug affordability & accessibility
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
Employer health plans must cover eye meds
If you have employer‑sponsored health insurance, your plan must cover post‑mastectomy care and topical eye medications. Plans must also follow other listed Illinois insurance protections. The Department of Insurance enforces these rules. This applies beginning January 1, 2028.
Medicaid covers post-mastectomy and eye medicine
Medicaid covers post‑mastectomy care and topical eye medications. The program must pay hospitals and doctors at least the Medicare rate for that care. Medicaid must also follow network adequacy and other listed protections. These rules apply starting January 1, 2028.
More coverage in state and local plans
The State Employee Group Insurance Program and self‑insured counties and cities must cover post‑mastectomy care and topical eye medications. They also must follow listed Illinois insurance protections. The Department of Insurance enforces parts on provider coverage, and Central Management Services enforces the rest. These rules take effect January 1, 2028.
More required benefits in HMOs and limited plans
HMOs, limited health service plans, and health services plan corporations must cover topical eye medications and follow listed Illinois insurance protections. Limited plans are not forced to cover services outside their defined scope. Some sections do not apply to plans under contract with the Department of Healthcare and Family Services. HMOs with at least 30% of enrollees living in Illinois are treated as Illinois 'domestic' for many insurance rules, strengthening state oversight. These changes take effect January 1, 2028.
Caps on HMO group refunds and surcharges
Your HMO group contract can include refunds or extra premiums based on your group’s claims. Any refund or extra charge is capped at 20% for the contract period, and contracts must last at least one year. These rules do not apply to small employer groups or Medicare supplement policies. HMOs must disclose that these adjustments are possible and explain the math on request. The rules start January 1, 2028.
Sponsors & Cosponsors
Sponsor
Laura Fine
Democratic • Senate
Cosponsors
Cristina Castro
Democratic • Senate
Graciela Guzmán
Democratic • Senate
Jawaharial Williams
Democratic • House
Mary Edly-Allen
Democratic • Senate
Mattie Hunter
Democratic • Senate
Mike Simmons
Democratic • Senate
Nicolle Grasse
Democratic • House
Rachel Ventura
Democratic • Senate
Sara Feigenholtz
Democratic • Senate
Roll Call Votes
House vote • 5/21/2026
Third Reading - Short Debate - Passed
Yes: 110 • No: 0
House vote • 5/6/2026
Do Pass / Short Debate Prescription Drug Affordability & Accessibility Committee;
Yes: 13 • No: 0
Senate vote • 4/14/2026
Third Reading - Passed;
Yes: 52 • No: 1
Senate vote • 3/4/2026
Do Pass as Amended Insurance;
Yes: 9 • No: 0
Actions Timeline
Public Act . . . . . . . . . 104-0649
7/24/2026SenateEffective Date January 1, 2028
7/24/2026SenateGovernor Approved
7/24/2026SenateAdded as Co-Sponsor Sen. Mary Edly-Allen
6/30/2026SenateSent to the Governor
6/18/2026SenateAdded Alternate Co-Sponsor Rep. Jawaharial Williams
5/21/2026HousePassed Both Houses
5/21/2026SenateThird Reading - Short Debate - Passed 110-000-000
5/21/2026HousePlaced on Calendar Order of 3rd Reading - Short Debate
5/19/2026HouseSecond Reading - Short Debate
5/19/2026HousePlaced on Calendar 2nd Reading - Short Debate
5/7/2026HouseDo Pass / Short Debate Prescription Drug Affordability & Accessibility Committee; 013-000-000
5/6/2026HouseAlternate Chief Sponsor Changed to Rep. Nicolle Grasse
4/29/2026HouseAssigned to Prescription Drug Affordability & Accessibility Committee
4/27/2026HouseAdded as Co-Sponsor Sen. Rachel Ventura
4/15/2026SenateReferred to Rules Committee
4/14/2026HouseFirst Reading
4/14/2026HouseChief House Sponsor Rep. Bob Morgan
4/14/2026HouseArrived in House
4/14/2026HouseThird Reading - Passed; 052-001-000
4/14/2026SenateAdded as Co-Sponsor Sen. Sara Feigenholtz
4/13/2026SenateAdded as Co-Sponsor Sen. Graciela Guzmán
3/27/2026SenateAdded as Co-Sponsor Sen. Mike Simmons
3/26/2026SenateAdded as Co-Sponsor Sen. Mattie Hunter
3/26/2026SenatePlaced on Calendar Order of 3rd Reading March 26, 2026
3/25/2026Senate
Bill Text
Engrossed
Enrolled
Introduced
Senate Amendment 1
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