Rep. Robyn Gabel

Filed: 3/7/2024

 

 


 

 


 
10300HB5142ham002LRB103 38742 RPS 70706 a

1
AMENDMENT TO HOUSE BILL 5142

2    AMENDMENT NO. ______. Amend House Bill 5142, AS AMENDED,
3with reference to page and line numbers of House Amendment No.
41, on page 1, line 5, by replacing "Section" with "Sections
5356z.4a and"; and
 
6on page 1, immediately below line 5, by inserting the
7following:
 
8    "(215 ILCS 5/356z.4a)
9    Sec. 356z.4a. Coverage for abortion.
10    (a) Except as otherwise provided in this Section, no
11individual or group policy of accident and health insurance
12that provides pregnancy-related benefits may be issued,
13amended, delivered, or renewed in this State after the
14effective date of this amendatory Act of the 101st General
15Assembly unless the policy provides a covered person with
16coverage for abortion care. Regardless of whether the policy

 

 

10300HB5142ham002- 2 -LRB103 38742 RPS 70706 a

1otherwise provides prescription drug benefits, abortion care
2coverage must include medications that are obtained through a
3prescription and used to terminate a pregnancy, regardless of
4whether there is proof of a pregnancy.
5    (b) Coverage for abortion care may not impose any
6deductible, coinsurance, waiting period, or other cost-sharing
7limitation that is greater than that required for other
8pregnancy-related benefits covered by the policy. This
9subsection does not apply to the extent such coverage would
10disqualify a high-deductible health plan from eligibility for
11a health savings account pursuant to Section 223 of the
12Internal Revenue Code.
13    (c) Except as otherwise authorized under this Section, a
14policy shall not impose any restrictions or delays on the
15coverage required under this Section.
16    (d) This Section does not, pursuant to 42 U.S.C.
1718054(a)(6), apply to a multistate plan that does not provide
18coverage for abortion.
19    (e) If the Department concludes that enforcement of this
20Section may adversely affect the allocation of federal funds
21to this State, the Department may grant an exemption to the
22requirements, but only to the minimum extent necessary to
23ensure the continued receipt of federal funds.
24(Source: P.A. 101-13, eff. 6-12-19; 102-1117, eff. 1-13-23.)";
25and
 

 

 

10300HB5142ham002- 3 -LRB103 38742 RPS 70706 a

1on page 3, line 3, after "Code.", by inserting "All outpatient
2coverage required under this subsection (b) must be provided
3without cost sharing, except that, for treatment of substance
4use disorders, the prohibition on cost-sharing applies to the
5levels of treatment below and not including 3.1 (Clinically
6Managed Low-Intensity Residential) established by the American
7Society of Addiction Medicine."; and
 
8on page 6, line 10, after the period, by inserting "All
9outpatient coverage required by paragraphs (2) through (6) of
10this subsection (b) must be provided without cost sharing,
11except that, for treatment of substance use disorders, the
12prohibition on cost-sharing applies to the levels of treatment
13below and not including 3.1 (Clinically Managed Low-Intensity
14Residential) established by the American Society of Addiction
15Medicine."; and
 
16on page 7, by replacing lines 7 through 11 with the following:
17    "(c) The cost-sharing prohibitions in this Section do not
18apply to the extent such coverage would disqualify a
19high-deductible health plan from eligibility for a health
20savings account pursuant to Section 223 of the Internal
21Revenue Code.".