HB5142: PREGNANCY/POSTPARTUM CARE

Legislative Summary

Reinserts the provisions of the bill as amended by House Amendment No. 1 with changes. Further amends the Illinois Insurance Code. Provides that coverage for abortion care may not impose any deductible, coinsurance, waiting period, or other cost-sharing limitation, except to the extent that the coverage would disqualify a high-deductible health plan from eligibility for a health savings account (rather than coverage for abortion care may not impose any deductible, coinsurance, waiting period, or other cost-sharing limitation that is greater than that required for other pregnancy-related benefits covered by the policy). Defines "perinatal doula" and "lactation consultant". Provides that coverage for postpartum services shall apply for all covered services rendered within the first 12 months after the end of pregnancy (rather than the coverage shall apply for at least one year after the end of pregnancy), except that a policy is not required to cover more than $8,000 for doula visits for each pregnancy and subsequent postpartum period. Provides that all outpatient coverage, other than health care services for home births, required under a provision concerning coverage for pregnancy, postpartum, and newborn care must be provided without cost sharing, except that, for mental health services, the cost-sharing prohibition does not apply to inpatient or residential services, and, for treatment of substance use disorders, the prohibition on cost-sharing applies to the levels of treatment below and not including Level 3.1 (Clinically Managed Low-Intensity Residential) established by the American Society of Addiction Medicine. Makes other changes. Effective January 1, 2026, except that certain changes to the Illinois Public Aid Code are effective January 1, 2025.