Several Wins for Illinois MS Activists During 2021 Session
June 10, 2021
Following a delayed start, the Illinois General Assembly adjourned on June 1, completing its work for the 2021 legislative session. With support from dedicated MS Activists across the state, we saw major wins on several issues which will improve the lives of people impacted by MS in Illinois.
- Access to affordable MS Medications: Out-of-pocket caps (also known as “copay reform”) protect patient access to more affordable copay coverage options for medications by requiring insurers to offer affordable out-of-pocket caps on 25% of their plans.
- Prior authorization reform: Prior authorization requirements require providers or patients to submit significant paperwork in order to have a disease modifying therapy covered by an insurer, reforms are needed to eliminate delays in care. Reform legislation holds insurance plans accountable for making timely prior authorizations determinations so that people living with MS receive the medications they need, when they need them.
- Disaster planning: The Access and Functional Needs Advisory Committee was created to provide recommendations to Illinois Emergency Management Agency (IEMA). The committee will research and provide recommendations for identifying and effectively responding to the needs of persons with access and functional needs before, during, and after a disaster using an intersectional lens for equity; provide recommendations regarding how to ensure that persons with a disability are included in disaster strategies and emergency management plans; and review and provide recommendations to integrate access and functional needs into the Illinois Emergency Operations Plan.
- Improved access to healthcare: Telehealth options for Illinoisans were expanded. The legislation aligns telehealth coverage and payment with in-person services, prioritizing appropriate patient access to care. Also included in the bill are stipulations barring insurers from requiring patients to prove hardship, prohibiting geographic or facility restrictions, establishing that a patient cannot be required to use telehealth services, and more.
As of June 10, these four bills have passed both chambers and have been sent to Governor Pritzker. It is expected he will sign them into law.
- Raised Awareness of MS: the Illinois legislature passed a resolution to recognize MS Awareness Week.
Additionally, two policies that the Society opposed were blocked.
- Protected access to comprehensive health care: For several years, legislation has been introduced to allow “association health plans” to proliferate. These junk plans cost less than ACA health plans, but they also cover less, and as written would have been able to skirt critical patient protections and state oversight. The Society opposed and successfully defeated the bill that would have expanded access to these plans.
- Protected access to affordable MS Medications: Illinois passed a copay accumulator ban in 2019, which requires all payments, including copay assistance, to count towards patients’ out-of-pocket maximums or deductibles. A new bill was introduced in 2021 to block copay assistance from counting on high deductible plans. This legislation did not pass, and the copay accumulator ban remains in place.
Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.