RELATING TO TAXATION.

2025 Regular Session Introduced by Nadine Nakamura

HB 1085 mandates insurance parity for mental health and substance use treatment in Illinois, ensuring equal coverage and access for residents starting January 2026.

Reported from HED (Stand. Com. Rep. No. 471) as amended in HD 2, recommending referral to FIN.

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Overview

Bill Number: HB 1085
Title: INS CD-MENTAL HEALTH PARITY
Introduced: January 2, 2025
Current Status: Added as Alternate Co-Sponsor Sen. Javier L. Cervantes on October 24, 2025
Primary Sponsor: Rep. Lindsey LaPointe

HB 1085 aims to enhance mental health and substance use disorder treatment coverage in Illinois by establishing parity in insurance reimbursement rates and ensuring comprehensive coverage for these services.

Purpose and Intent

The primary intent of HB 1085 is to ensure that mental health and substance use disorder treatment services are covered by insurance policies on par with physical health services. This legislation seeks to address disparities in treatment access and reimbursement, thereby improving mental health care for Illinois residents.

Key Provisions

Insurance Coverage Requirements:

Mandates that all group or individual policies of accident and health insurance or managed care plans amended, delivered, issued, or renewed on or after January 1, 2026, must cover medically necessary mental health and substance use disorder treatment services.
Establishes reimbursement rates for these services effective January 1, 2027.

Civil Penalties:

If the Illinois Department of Insurance determines that an insurer or a contracted third party has violated mental health and substance use parity provisions, a civil penalty of $1,000 per violation will be assessed.

Exemptions:

Certain health care plans serving Medicaid populations under the Illinois Public Aid Code or the Children's Health Insurance Program Act are excluded from these parity provisions.

Impact Review:

The Department of Insurance is required to review the impact of the mental health and substance use mandate on network adequacy and access to affordable care, including an examination of out-of-network utilization and out-of-pocket costs.

Amendments to Existing Codes:

The bill amends the State Employees Group Insurance Act, Counties Code, Illinois Municipal Code, and School Code to require compliance with the new coverage standards.

Who Would Be Affected?

Insurance Providers: Must adjust their policies to comply with the new coverage requirements.

Employers: Particularly those who are self-insurers, will need to ensure their health plans meet the new standards.

Employees and Residents: Individuals seeking mental health and substance use disorder treatment will benefit from improved access and coverage.

Procedural Aspects

The bill has undergone several amendments and has been re-referred to various committees since its introduction.

Significant actions include:

Senate Committee Amendment No. 2 filed on May 30, 2025.
The bill was passed in the House on April 7, 2025, and is currently in the Senate for further consideration.

Conclusion

HB 1085 represents a significant step towards improving mental health care access in Illinois by mandating insurance parity for mental health and substance use disorder treatment. The bill's provisions aim to ensure that individuals receive equitable treatment options, thereby addressing a critical public health issue.

Bill