Illinois Legislature Passes Bill to Improve Access to Therapists

Finding therapists who accept insurance could soon get easier for Illinois residents. Governor J.B. Pritzker recently signed a bill aimed at enhancing reimbursement rates for behavioral health services.

This new legislation, set to take effect in January 2027, introduces a formula for how much therapists should be reimbursed by insurance companies. There’s also a goal to streamline the complicated processes that many therapists encounter when working with insurers.

In the past few years, a number of therapists have opted out of private insurance due to low and stagnant reimbursement rates. This shift has complicated matters for patients, who often struggle to find therapists that accept their insurance. Many have had to forego treatment or pay out of pocket.

“Patients will have better options to use private insurance across various behavioral health services, meaning they won’t have to shoulder costs themselves or skip treatment,” stated bill sponsor Rep. Lindsey Lapointe (D-Chicago).

The law also takes steps to prevent insurance companies from requiring extra documentation for missed 60-minute sessions. Insurers will now have to cover multiple behavioral health services in a single day for each patient. Additionally, services provided by therapists-in-training who are supervised by licensed professionals will be covered. Another focus of the law is to lessen the time it takes for therapists to become in-network with insurance providers.

The bill passed through Congress in October, despite pushback from insurance industry representatives, who raised concerns over statutory reimbursement rates and potential cost increases for consumers.

The insurance group AHIP commented recently that it is still collaborating with policymakers “to develop solutions that enhance affordability and accessibility for mental health and substance abuse care.”

This new law benefits around 2.5 million Illinois residents on state-regulated health insurance plans. However, it does not affect individuals with HMOs or state employees, as there were worries it could increase costs for the state—a point disputed by Lapointe.

LaPointe, along with supporters from Thresholds, has been advocating for this measure for several years. Thresholds provides support for people with severe mental health and substance use disorders in Illinois.

Previously, insurers needed to pay in-network therapists 141% of Medicare’s rates for treatment and substance use services. The recently passed bill omits the specific 141% figure, opting instead for a formula that roughly amounts to that percentage, according to Lapointe.

“After three years of work, we are witnessing Illinois make a significant move towards improving access to care by bringing more behavioral health providers into network,” Lapointe remarked. “We couldn’t have introduced this bill sooner; it’s crucial for making healthcare more affordable, especially at a time when Medicaid and ACA marketplaces face uncertainties.”

Alison Steiger, a licensed clinical social worker in Ravenswood, expressed that the bill would “truly help sustain therapists in their everyday practices.” However, she pointed out that more work remains to streamline interactions between therapists and insurance companies.

“I think this is a step forward in fairly compensating therapists and raising the profile of our field to a more valued status,” Steiger added.