Illinois 103rd Regular Session Status: In Committee 23 D cosponsors

HB 4504 — INS CD-INHALER COVERAGE

Last action — Rule 19(a) / Re-referred to Rules Committee

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 103rd Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Amends the Illinois Insurance Code. Provides that a health plan shall limit the total amount that a covered person is required to pay for a covered prescription inhaler at an amount not to exceed $25 per 30-day supply and shall limit the total amount that a covered person is required to pay for all covered prescription inhalers at an amount not to exceed $50 in total per 30 days. Provides that coverage for prescription inhalers shall not be subject to any deductible. Provides that nothing in the provisions prevents a health plan from reducing a covered person's cost sharing to an amount less than the cap. Authorizes rulemaking and enforcement by the Department of Insurance. Effective January 1, 2025.

Bill Text

What changed in the latest version

105 added · 57 removed

Plain-language change summary

The recent changes to Bill HB 4504 enhance coverage for prescription inhalers, capping the out-of-pocket cost at $25 for a 30-day supply and a total of $50 for all inhalers within the same period. Additionally, these benefits will not apply towards any deductibles, making access to necessary medication more affordable for patients. This amendment is important because it aims to alleviate the financial burden on individuals who rely on these essential devices for their health, ensuring that they can obtain them without excessive costs.

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Latest
*LRB10336828RPS66939b* HB4504 103RD GENERAL ASSEMBLY State of Illinois and 2024 HB4504 Introduced 1/31/2024, by Rep.
HB4504 Engrossed LRB103 36828 RPS 66939 b AN ACT concerning regulation.
Laura Faver Dias SYNOPSIS AS INTRODUCED:
ILCS 5/356z.71 new Amends the Illinois Insurance Code.
Provides that a health plan shall limit the total amount that a covered person is required to pay for a covered prescription inhaler at an amount not to exceed $25 per 30-day supply and shall limit the total amount that a covered person is required to pay for all covered prescription inhalers at an amount not to exceed $50 in total per 30 days.
Provides that coverage for prescription inhalers shall not be subject to any deductible.
Provides that nothing in the provisions prevents a health plan from reducing a covered person's cost sharing to an amount less than the cap.
Authorizes rulemaking and enforcement by the Department of Insurance.
Effective January 1, 2025.
LRB103 36828 RPS 66939 b A BILL FOR HB4504 LRB103 36828 RPS 66939 b AN ACT concerning regulation.
The Illinois Insurance Code is amended by adding Section 356z.71 as follows:
The State Employees Group Insurance Act of 1971 is amended by changing Section 6.11 as follows:
(215 ILCS 5/356z.71 new) Sec.
(5 ILCS 375/6.11) Sec.
356z.71.
6.11.
Prescription inhalers.
Required health benefits;
(a) In this Section:
Illinois Insurance Code requirements.
"Health plan" means a policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after the effective date of this amendatory Act of the 103rd General Assembly that provides coverage for prescription inhalers.
The program of health benefits shall provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t of the Illinois Insurance Code.
"Prescription inhaler" means a prescribed medical device that delivers inhaled medications used to treat respiratory conditions and the prescribed inhaled medication.
The program of health benefits shall provide the coverage required under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x, 356z.2, 356z.4, 356z.4a, 356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, 356z.60, and 356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70 of the Illinois Insurance Code.
The program of health benefits must comply with Sections 155.22a, 155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois Insurance Code.
The program of health benefits shall HB4504 Engrossed - 2 - LRB103 36828 RPS 66939 b provide the coverage required under Section 356m of the Illinois Insurance Code and, for the employees of the State Employee Group Insurance Program only, the coverage as also provided in Section 6.11B of this Act.
The Department of Insurance shall enforce the requirements of this Section with respect to Sections 370c and 370c.1 of the Illinois Insurance Code;
all other requirements of this Section shall be enforced by the Department of Central Management Services.
Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules;
any purported rule not so adopted, for whatever reason, is unauthorized.
(Source:
P.A.
102-30, eff.
1-1-22;
102-103, eff.
1-1-22;
102-203, eff.
1-1-22;
102-306, eff.
1-1-22;
102-642, eff.
1-1-22;
102-665, eff.
10-8-21;
102-731, eff.
1-1-23;
102-768, eff.
1-1-24;
Show all 85 changed rows (45 more)
Previous
Latest
102-804, eff.
1-1-23;
102-813, eff.
5-13-22;
102-816, eff.
1-1-23;
102-860, eff.
1-1-23;
102-1093, eff.
1-1-23;
102-1117, eff.
1-13-23;
103-8, eff.
1-1-24;
103-84, eff.
1-1-24;
103-91, eff.
1-1-24;
103-420, eff.
1-1-24;
103-445, eff.
1-1-24;
103-535, eff.
8-11-23;
103-551, eff.
8-11-23;
revised 8-29-23.) Section 10.
The Illinois Insurance Code is amended by changing Section 356z.5 as follows:
HB4504 Engrossed - 3 - LRB103 36828 RPS 66939 b (215 ILCS 5/356z.5) Sec.
356z.5.
Prescription inhalants.
(a) In this Section, "prescription inhaler" means a prescribed medical device that delivers inhaled medications used to treat breathing for persons suffering from asthma or other life-threatening bronchial ailments.
(b) A health plan shall limit the total amount that a covered person is required to pay for a covered prescription HB4504 - 2 - LRB103 36828 RPS 66939 b inhaler to an amount not to exceed $25 per 30-day supply and shall limit the total amount that a covered person is required to pay for all covered prescription inhalers to an amount not to exceed $50 in total per 30 days.
(b) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed through December 31, 2025 after the effective date of this amendatory Act of the 93rd General Assembly that provides coverage for prescription drugs may not deny or limit coverage for prescription inhalers inhalants to enable persons to breathe when suffering from asthma or other life-threatening bronchial ailments based upon any restriction on the number of days before an inhaler refill may be obtained if, contrary to those restrictions, the inhalants have been ordered or prescribed by the treating physician and are medically appropriate.
Coverage for prescription inhalers shall not be subject to any deductible.
(c) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2026 that provides coverage for HB4504 Engrossed - 4 - LRB103 36828 RPS 66939 b prescription drugs may not deny or limit, except as otherwise provided in this subsection, coverage for prescription inhalers to enable persons to breathe when suffering from asthma or other life-threatening bronchial ailments based upon any restriction on the number of days before an inhaler refill may be obtained if, contrary to those restrictions, the inhalants have been ordered or prescribed by the treating physician and are medically appropriate.
(c) Nothing in this Section prevents a health plan from reducing a covered person's cost sharing to an amount less than the amount specified in subsection (b).
A group or individual policy of accident and health insurance or managed care plan subject to this subsection shall limit the total amount that a covered person is required to pay for a covered prescription inhaler to an amount not to exceed $25 dollars per 30-day supply.
(d) The Department may adopt rules necessary to implement and administer this Section and to align with federal requirements.
(d) Nothing in this Section prevents a group or individual policy of accident and health insurance or managed care plan from reducing a covered person's cost sharing to an amount less than the amount specified in subsection (c).
The Department may use any of its enforcement powers to obtain a health plan's compliance with this Section.
(e) Coverage for prescription inhalers shall not be subject to any deductible;
Section 99.
except that this provision does not apply to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to Section 223 of the Internal Revenue Code (26 U.S.C.
Effective date.
223).
This Act takes effect January 1, 2025.
(f) The Department may adopt rules necessary to implement and administer this Section and to align with federal requirements.
The Department may use any of its enforcement HB4504 Engrossed - 5 - LRB103 36828 RPS 66939 b powers to obtain a group or individual policy of accident and health insurance's or managed care plan's compliance with this Section.
(Source:
P.A.
95-331, eff.
8-21-07.)
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How this bill changes current law

3 changes Share ↗

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill modifies health insurance requirements under the State Employees Group Insurance Act and the Illinois Insurance Code related to post-mastectomy care and prescription inhalers.

  • 5 ILCS 375/6.11

    for the employees of the State Employee Group Insurance Program only, the coverage as also provided in Section 6.11B of this Act.

    Adds specific coverage requirements for employees of the State Employee Group Insurance Program.

  • 215 ILCS 5/356z.5

    A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2026 that provides coverage for prescription drugs may not deny or limit, except as otherwise provided in this subsection, coverage for prescription inhalers to enable persons to breathe when suffering from asthma or other life-threatening bronchial ailments based upon any restriction on the number of days before an inhaler refill may be obtained if, contrary to those restrictions, the inhalants have been ordered or prescribed by the treating physician and are medically appropriate. → A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2026 that provides coverage for prescription drugs may not deny or limit, except as otherwise provided in this subsection, coverage for prescription inhalers to enable persons to breathe when suffering from asthma or other life-threatening bronchial ailments based upon any restriction on the number of days before an inhaler refill may be obtained if, contrary to those restrictions, the inhalants have been ordered or prescribed by the treating physician and are medically appropriate. A group or individual policy of accident and health insurance or managed care plan subject to this subsection shall limit the total amount that a covered person is required to pay for a covered prescription inhaler to an amount not to exceed $25 dollars per 30-day supply.

    Changes the limit on cost-sharing for prescription inhalers and establishes a copayment maximum.

  • 215 ILCS 5/356z.5

    Coverage for prescription inhalers shall not be subject to any deductible; except that this provision does not apply to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to Section 223 of the Internal Revenue Code (26 U.S.C. 223).

    Clarifies that prescription inhaler coverage isn't subject to deductibles, preserving high-deductible health plan eligibility.

Amendments

1 amendment

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Action History

  1. Rule 19(a) / Re-referred to Rules Committee

  2. Added Co-Sponsor Rep. Kevin John Olickal

  3. Added Co-Sponsor Rep. Robyn Gabel

  4. Added Co-Sponsor Rep. Maurice A. West, II

  5. Added Co-Sponsor Rep. Sue Scherer

  6. Added Co-Sponsor Rep. Stephanie A. Kifowit

  7. Added Co-Sponsor Rep. Robert "Bob" Rita

  8. Added Co-Sponsor Rep. Katie Stuart

  9. Added Co-Sponsor Rep. Jenn Ladisch Douglass

  10. Placed on Calendar Order of 3rd Reading - Short Debate

  11. Second Reading - Short Debate

  12. Added Co-Sponsor Rep. Diane Blair-Sherlock

  13. Added Co-Sponsor Rep. Dave Vella

  14. Added Co-Sponsor Rep. Emanuel "Chris" Welch

  15. Added Co-Sponsor Rep. Terra Costa Howard

  16. Added Co-Sponsor Rep. Joyce Mason

  17. Chief Co-Sponsor Changed to Rep. Marcus C. Evans, Jr.

  18. Added Chief Co-Sponsor Rep. Marcus C. Evans, Jr.

  19. Added Chief Co-Sponsor Rep. Harry Benton

  20. Placed on Calendar 2nd Reading - Short Debate

  21. Added Chief Co-Sponsor Rep. Camille Y. Lilly

  22. Added Chief Co-Sponsor Rep. Jawaharial Williams

  23. Do Pass as Amended / Short Debate Insurance Committee; 010-002-000

  24. House Committee Amendment No. 1 Adopted in Insurance Committee; by Voice Vote

  25. House Committee Amendment No. 1 Rules Refers to Insurance Committee

  26. Added Co-Sponsor Rep. Martin J. Moylan

  27. Added Co-Sponsor Rep. Yolonda Morris

  28. Added Co-Sponsor Rep. Eva-Dina Delgado

  29. House Committee Amendment No. 1 Referred to Rules Committee

  30. House Committee Amendment No. 1 Filed with Clerk by Rep. Laura Faver Dias

  31. Added Co-Sponsor Rep. Rita Mayfield

  32. Added Co-Sponsor Rep. La Shawn K. Ford

  33. Assigned to Insurance Committee

  34. Removed Co-Sponsor Rep. Camille Y. Lilly

  35. Added Co-Sponsor Rep. Abdelnasser Rashid

  36. Added Co-Sponsor Rep. Camille Y. Lilly

  37. Referred to Rules Committee

  38. First Reading

  39. Filed with the Clerk by Rep. Laura Faver Dias

Sponsors

Sponsorship breakdown

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1 sponsors · 23 co-sponsors · 159 not signed on · 2 voted No

Sponsors (1)

Co-sponsors (23)

Not signed on (159)

159 members have not signed on to this bill.

Show all 159 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Insurance

Passed 10 Yea · 2 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 3000
Democrat 6002
Republican 1201
Total 10203
% of votes cast 67%13%0%20%
How each member voted (15)
Member Party Vote
Katz Muhl — Yea
La Ha — Yea
Williams, Jawaharial — Yea
Anthony DeLuca Democrat Yea
Bob Morgan Democrat Yea
Camille Y. Lilly Democrat Yea
Joyce Mason Democrat Not Voting
La Shawn K. Ford Democrat Yea
Margaret Croke Democrat Not Voting
Rita Mayfield Democrat Yea
Thaddeus Jones Democrat Yea
Adam M. Niemerg Republican Nay
Jeff Keicher Republican Yea
Travis Weaver Republican Not Voting
William E Hauter Republican Nay

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HB 4504 do?
Amends the Illinois Insurance Code. Provides that a health plan shall limit the total amount that a covered person is required to pay for a covered prescription inhaler at an amount not to exceed $25 per 30-day supply and shall limit the total amount that a covered person is required to pay for all covered prescription inhalers at an amount not to exceed $50 in total per 30 days. Provides that coverage for prescription inhalers shall not be subject to any deductible. Provides that nothing in the provisions prevents a health plan from reducing a covered person's cost sharing to an amount less than the cap. Authorizes rulemaking and enforcement by the Department of Insurance. Effective January 1, 2025.
Who sponsors HB 4504?
HB 4504 is sponsored by Ladisch Douglass, Camille Y. Lilly (Democrat), Harry Benton (Democrat), Marcus C. Evans, Jr. (Democrat), Abdelnasser Rashid (Democrat), La Shawn K. Ford (Democrat), Rita Mayfield (Democrat), Eva-Dina Delgado (Democrat), Yolonda Morris (Democrat), Joyce Mason (Democrat), Emanuel "Chris" Welch (Democrat), Dave Vella (Democrat), Diane Blair-Sherlock (Democrat), Katie Stuart (Democrat), Robert "Bob" Rita (Democrat), Stephanie A. Kifowit (Democrat), Sue Scherer (Democrat), Maurice A. West, II (Democrat), Robyn Gabel (Democrat), Kevin John Olickal (Democrat), Terra Costa Howard (Democrat), Martin J. Moylan (Democrat), Jawaharial Williams (Democrat), and Laura Faver Dias (Democrat).
What is the current status of HB 4504?
This bill died with 103rd Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HB 4504?
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