Illinois Gov. JB Pritzker lays out fiscal 2025 budget priorities

Children were the organizing principle of Illinois Gov. JB Pritzker’s sixth State of the State and budget address Wednesday, in which he said his “one line in the sand” is that he will only sign a “responsibly balanced” budget that does not derail the state’s credit standing or the nine to fund the pensions.

Pritzker also took a swing at health insurance companies, saying he will introducing a bill to “curb predatory insurance practices,” the HCAP Act, which has three planks. The first cracks down on “utilization management” – an insurance industry term for practices such as prior authorization and step therapy, which frequently results in insurance company denials of doctor-prescribed treatments – and bans short-term, limited insurance plans known as “junk insurance.”

“Any doctor will tell you how much they loathe these practices,” Pritzker said. “Almost everyone has a horror story about prior authorizations and step therapy.” 

The second plank of the bill strengthens protections around “network adequacy,” Pritzker said, punishing insurers for “ghost networks” that feature directories of supposed in-network doctors, many of whom aren’t actually accepting patients. And the third plank reins in “unchecked rate increases,” he explained, banning insurance companies from unfairly raising rates on consumers.

“I know how hard the insurance industry will fight me on this,” Pritzker said, after relating the story of a man who was denied coverage for open-heart surgery days before the procedure was to take place. “But I’m willing to spend serious political capital on this.”

Overall, his 2025 budget required some “hard choices,” he added, but: “It’s important to note that while this budget is tight, our fiscal house is in order. Because of the responsible actions we took in the last few years… we are not facing the budgetary challenges that other big states are.”