Legislation protects health care providers from legal action, expands guaranteed insurance coverage, and increases reproductive health access

Chicago -- On Jan 13th, Governor JB Pritzker signed HB4664, a reproductive rights and gender affirming care omnibus bill that protects health care providers and their patients from legal attacks by neighboring states and expands health care access and options across the state. The bill takes historic action to protect Illinois providers and their patients, thousands of whom have travelled to Illinois to access essential reproductive health care now banned in their home states.

“Here in Illinois, we hold certain ideals: abortion is health care. A medical decision should be made between a patient and their doctor — no one else,” said Governor JB Pritzker. “Last summer, when Roe v. Wade was overturned, I made a promise that Illinois would remain a beacon of hope and an island for reproductive justice for all who seek it. This bill fulfills that promise.”

As patients come to Illinois from surrounding states to seek reproductive health care in the wake of the overturning of Roe v. Wade, many providers fear legal action from reactionary state governments for providing essential care. Illinois sees over 10,000 patients a year from other states for abortion care, and that number has increased dramatically since June of 2022. The bill shields individuals from civil and criminal discovery from other states, and extraditions related to providing reproductive health care.

The act also expands access to reproductive health care by broadening the scope of care certain health care professionals can provide and ensuring insurance coverage for necessary care. Under the act, Advanced Practice Registered Nurses and Physicians Assistants can provide scope-appropriate abortion care. It also allows birth centers to provide broad-spectrum reproductive health care in addition to their current offerings to pregnant people and new parents. The act takes major steps to expand access by guaranteeing that abortion medications, PEP/PrEP, and gender-affirming care be covered by insurers at no extra cost to consumers and requires local government employers to offer insurance plans that provide coverage for these treatments, as well as for birth control.

Among other provisions, the act also strengthens protections for families using assisted reproductive treatments like IVF or surrogacy. The act adds “assisted reproduction” to the definition of reproductive health care protected under this act and under the Reproductive Health Act (RHA) Governor Pritzker signed into law in 2019. The RHA guaranteed private insurance coverage for abortion services and reaffirmed Illinoisans right to essential reproductive care.

“In Illinois, we know that everyone has a right to reproductive care and critical services that help people be their healthy, authentic selves,” said Lt. Governor Juliana Stratton. “This decisive, affirming legislation broadens and protects access for ourselves and for future generations. What we do now will shape justice and equity going forward as we create an Illinois that is a safe space for all.”

“The fight for access to reproductive and gender-affirming care does not end here,” Attorney General Kwame Raoul said. “We must continue our work to ensure Illinois remains a health care oasis for anyone seeking care. In Illinois, we support a woman’s right to choose, we support transgender youth and their families, and we support the medical professionals who perform these essential services every day.”

“Six months ago we mourned a dark day for our nation and stood together to promise that in Illinois, we would not go back,” said House Speaker Emanuel "Chris" Welch. “When we take away the right to choose, we get rid of equality and freedom. On Jan 13th, we celebrate our progress in Illinois without forgetting those whose freedoms are still under attack.”

“In Illinois, we trust women, and we will protect their right to make their own decisions about their health care and their bodies,” said Senate President Don Harmon. “This new law sends a strong message that we will fortify our state against current and future attacks on bodily autonomy from those looking to reverse progress and remove rights.”

“Everyone deserves to have access to safe and legal health care,” said State Senator Julie Morrison (D-Lake Forest). “We must preserve that right while ensuring that medical professionals’ jobs won’t be in jeopardy due to restrictive, overarching laws of other states.”

Though many have used the Dobbs decision to strip vulnerable people of their right to choose, Illinois has once again stood up to an extremist, anti-choice agenda by protecting reproductive freedoms,” said State Rep. Dagmara Avelar (D-Bolingbrook). “On Jan 13th’s action will save lives, expand access to critical medical care, and protect the right to bodily autonomy. As elected officials, we must use the full weight of our position to defend these essential rights and freedoms.”

“The House Reproductive Health and Dobbs Decision Working Group and I were tasked with creating consensus around policy that would secure meaningful protections for patients and providers of reproductive and gender affirming care, and we have delivered on that mandate,” said State Rep. Kelly Cassidy (D-Chicago). “This comprehensive legislation is proof that Illinois does not and will not stand by as hard-fought freedoms of the people of this state are taken away. It is further proof that protecting reproductive rights and gender affirming healthcare is broadly supported, contrary to Republican-led efforts to strip away the protections we all rely on. By partnering with community stakeholders, organizations, and our government colleagues, we are setting the example for other states and their reproductive and healthcare policy in a post-Roe world.”

“The outrageous restrictions extremists in other states are placing on a woman's right to choose unquestionably affect Black and low-income communities the most, and we cannot allow other states' recklessness to affect our rights in Illinois,” said State Rep. Lakesia Collins (D-Chicago). “This bill continues our effort to move Illinois in a fundamentally better direction. As lawmakers, stopping restrictions of bodily autonomy and bans of, at times, lifesaving procedures, is our duty. This measure is a significant step towards ensuring those restrictions never happen in Illinois.”

“Reproductive freedom is a fundamental human right,” said State Rep. Terra Costa Howard (D-Glen Ellyn). “This new law underscores our commitment to making sure that everyone in Illinois has access to full reproductive health care, without exception.”

“In a post-Roe state of reproductive rights and freedoms, Illinois stood up to extremist bullies who play games with women’s lives,” said State Rep. Anna Moeller (D-Elgin). “While Republican-led states seek to prosecute women and medical professionals for abortion services, we won’t. Instead, we are making it easier for medical professionals to work here and help these vulnerable populations through their difficult medical decisions. And while some states want to turn back the clock on LGBTQ+ rights, we won’t. Instead, we’re making it easier to access life-saving HIV prevention medication and other services that affirm trans people’s existence.”

"As state after state moves to restrict and ban access to reproductive healthcare, we are taking steps to ensure access to these critical services - for those in Illinois and beyond," said State Rep. Ann Williams (D-Chicago). "We will continue to do the work to make sure people have the right to make their own healthcare decisions - and stand strong against those seeking to eliminate this basic right."

“On Jan 13th, we are living up to our promise to all people in this country that Illinois will protect and defend your fundamental right to make decisions about your own body and family,” said State Senator Cristina Castro (D-Elgin). “This law is especially impactful for communities of color, low-income, and working class people who bear the greatest risk in traveling from out-of-state to access reproductive care.”

“Our actions today make certain that everyone in our state – whether they live here or not – will maintain the fundamental right to all forms of reproductive health care,” said State Senator Sara Feigenholtz (D-Chicago). “I am proud to stand in support of the protections offered in House Bill 4664 and to send the strong and clear message: we will not go back. This law reaffirms our commitment as a state to secure and defend our reproductive freedoms.”

“The Dobbs decision showed us that these federal courts will not respect the rights so many have fought so hard to defend – and that we cannot take these rights for granted,” said Former Majority Leader Greg Harris (D-Chicago). “States are now the final line of defense for reproductive health care, gender-affirming care, contraception access, and LGBTQ rights. That’s why we are fortunate In Illinois to have leaders like Governor Pritzker, Speaker Welch, Representative Cassidy, and our advocate community who will always be a voice for those who extremists would silence.”

“At a time when reproductive rights are under attack across the country, Illinois is sending a strong message that we are a place where all women can access the care they need,” said State Rep. Margaret Croke (D-Chicago). “This legislation further establishes Illinois as not only the most pro-choice state in the country, but a safe haven for those across the Midwest whose freedoms have been taken away from them. I’m particularly proud that my bill to ensure protections for people who are starting their families through IVF and other reproductive technology is included in this package, and I’m grateful to Governor JB Pritzker for signing it into law.”

“As a result of Roe vs. Wade being overturned by the Supreme Court, House Bill 4664 was put in place for the protection of Illinois residents who seek reproductive health care and or gender-affirming care in Illinois,” said Senator Celina Villanueva (D-Chicago). “Taking away someone’s right to choose is a violation of human rights. All residents deserve the right to equal healthcare options no matter what their circumstance is. As Illinois is a gender inclusive state, we must do all we can to make sure individuals who are seeking gender affirming care, can receive the help and support they need to live a happy, and healthy life without penalty. By passing this measure, we will be able to generate proper healthcare resources to an underserved community that will be life changing, and we will protect women’s right to choose life.”

“Over the lame duck session and for months before that in Senate working groups, we fought hard for robust protections for reproductive rights, added capacity for those who need abortions, and training for health workers to provide reproductive health care," said State Senator Mike Simmons (D-Chicago). "We also spoke up and made sure protections were included for medical refugees who need gender-affirming care, which is under attack in so many states right now. I am inspired by how we got to this point, and our constituents can rest easy knowing Illinois remains a strong state for reproductive justice and LGBTQ+ healthcare. Women, transgender, and nonbinary people of all backgrounds should make decisions about their bodies and their healthcare, and I will always stand with them in this fight."

“Everyone deserves to have access to safe and legal reproductive health care. We must preserve the rights of women and the professionals who perform these services,” said State Senator Laura Murphy (D-Des Plaines). “This blanket protection for reproductive health care ensures that Illinois remains a step ahead of states trying to outlaw such care. Women have the fundamental right to make their own health care decisions, and should not be punished due to restrictive, overreaching laws.”

“As a result of the leadership of Governor Pritzker, Speaker Welch, Senate President Harmon, Rep. Cassidy, Sen. Villanueva, and the work of countless advocates and allies including the House Dobbs Decision Working Group, Illinois has now enacted legislation that provides a safe haven for Illinois families and health care providers,” said Lambda Legal Senior Attorney Kara Ingelhart. “We at Lambda Legal are immensely grateful for the incredible work that went into this law, and to the elected officials and advocates who recognized the intrinsic and inseverable link between reproductive freedom and LGBTQ+ rights, that neither can progress or be adequately defended without the other. This legislation should serve as an example to other states on how we work together to protect our freedoms and enact robust protections for trans people and abortion rights.”

“Gender affirming care is necessary and often life-saving healthcare, and healthcare is a human right,” said David Ernesto Munar, President and CEO of Howard Brown Health. “As states all across the country continue to attack trans and non-binary communities, it is critical that Illinois remain a safe haven for all who need access to reproductive and gender affirming care. We are grateful that our state legislature and Governor Pritzker have taken a strong stance in support of our patients and our providers.”

“Thank you, Governor Pritzker, for signing this law to protect health care refugees forced to flee their home state to receive abortion and gender-affirming care in Illinois,” said Jennifer Welch, President and CEO of Planned Parenthood Illinois Action. “We applaud this law for including crucial protections for Illinois providers, plus clinicians traveling to our state to offer care that patients need and deserve and allowing practitioners to provide the medical procedures to the extent of their training. In the ever-shifting post-Roe national landscape, Illinois is a leader in the fight for bodily autonomy and a haven to those seeking and providing essential health care.”

“Illinois prepared for the day that a reckless Supreme Court stripped away the constitutional right to an abortion that had been guaranteed for nearly a half century. That action has emboldened hostile legislators in other states to contemplate enforcing their bans on abortion and gender-affirming health care outside their own boundaries, including in Illinois,” said Khadine Bennett, Advocacy and Intergovernmental Affairs Director ACLU of IL or the ACLU of IL. “This new law builds on current law and enhances protections for providers and patients seeking abortion and gender-affirming health care in our state. This is a critical and necessary step.”

"Reproductive rights are LGBTQ+ rights. Our rights are inextricably linked by substantive due process claims to rights to privacy, bodily autonomy, and the liberty to form one’s own family,” said Mony Ruiz-Velasco, Deputy Director Equality Illinois. “With LGBTQ+ communities across the country under attack in real time, and particularly against trans youth, this essential legislation will save lives by ensuring meaningful access to gender affirming and reproductive healthcare and by providing important protections to patients, families and providers. Illinois is a beacon of hope and refuge for those seeking protection to fundamental rights."

A comprehensive list of amendments in the bill can be read below:

• Shields individuals in Illinois from foreign subpoenas, summons, or extraditions related to lawful reproductive or gender affirming care in Illinois. Requires courts in Illinois to apply Illinois law in cases involving reproductive health care.

• Requires the Department of Public Health to partner with organizations to provide grants for abortion training.

• Clarifies that Advanced Practice Registered Nurses and Physicians Assistants can perform abortions consistent with their training and within their scope of practice.

• Requires local units of government including schools, municipalities, and counties that offer health insurance plans to provide coverage for contraceptives, and if they offer pregnancy-related benefits, abortion.

• Requires abortifacients (i.e., medications administered to terminate a pregnancy), gender-affirming health care medications, and PEP/PrEP medication (i.e., HIV treatment) to be covered by insurers at no-cost to the consumer.

• Prevents insurers from charging higher out-of-pocket costs for certain insurance plans when patients are forced to seek out-of-network provider care due to an in-network provider raising moral objections under the Health Care Right of Conscience Act.

• Expands access to reproductive health care by permitting birth centers in Illinois to provide full spectrum reproductive health care and sexual health care, instead of only childbirth-related needs of pregnant persons and their newborns.

• Allows patients to receive hormonal birth control over the counter from a pharmacist pursuant to a standing order from the Illinois Department of Public Health.

• Establishes a counterclaim for individuals who have a judgement entered against them in another state for reproductive health care that is legal in Illinois.

• Clarifies that no person is subject to civil liability for receiving an abortion under the Wrongful Death Act, clarifies that no hospital personnel shall report an abortion to law enforcement agencies, and clarifies that the statute of limitations under the Reproductive Health Act is 2 years.

• Amends the Parentage Act:

o Allows intended parents or parents to dispose of any cryopreserved fertilized ovum to be governed by the intended parent’s or parent’s most recent informed consent or under a marital settlement agreement.

o Allows for the establishment of a parent-child relationship in the event of gestational surrogacy wherein the intended parent dies; and

o Allows an out-of-state physician to certify the genetic make-up of embryos.

• Adds “assisted reproduction” to the definition of reproductive health care in the Reproductive Health Act. “Assisted Reproduction” means a method of achieving a pregnancy through the handling of human oocytes, sperm, zygotes, or embryos for the purpose of establishing a pregnancy.

• Prevents the Illinois Department of Financial and Professional Regulation (IDFPR) from taking disciplinary action against any health care professional licensed under the Division of Professional Regulation Acts governed by IDFPR based solely upon the license of the professional being disciplined by any state for providing or participating in any health care that is legal in Illinois, regardless of whether it is legal in the other state.

• Allows IDFPR to establish expedited, temporary licenses for out-of-state healthcare professionals seeking to provide healthcare in Illinois. Allows these licensees to offer telehealth.

• Amends the Wrongful Death Act to prohibit someone from asserting a claim as a result of a lawful abortion.

• Adds additional protections for healthcare providers and facilities from being punished for providing abortions and related services.