The Illinois legislature’s spring session ended with it signing off on a series of measures setting up protections for LGBTQ+ people, trans foster youth and those seeking abortions — though progressive lawmakers are still looking ahead at where gaps may lie in state law.
One bill would prevent hormone therapy and medication abortion from being tracked by the state’s Prescription Monitoring Program, while another would give patients greater control over medical data that is ported to nationwide databases.
Gov. JB Pritzker has already pledged to sign both bills. Still, legislators said there is some way to go — and they need to get creative as federal and state governments clash on other issues.
“We have to protect as many people as we can, for as long as we can, as reliably as we can,” said Rep. Kelly Cassidy, D-Chicago. “Inherent in that statement is an admission of the limitations of our powers. Nothing is going to stop a federal subpoena or protect against a federal ban. … We’re making a safety net as we fly.”
Protections for reproductive rights and gender-affirming care were enshrined in state law in January 2023, putting Illinois on the side of people who risk prosecution by traveling to the state for treatment and also protecting the licenses of Illinois doctors who provide care that’s illegal elsewhere. The Illinois Human Rights Act also protects against discrimination based on gender identity.
But the Donald Trump administration has claimed gender-affirming care is “harmful,” putting it at odds with dozens of major medical organizations, but still leading many hospitals across the nation, including in the Chicago area, to cut treatment for thousands of patients out of fear of reprisals from the federal government.
Some bills make progress on goals some legislators had laid out when Trump was elected for a second time. Cassidy said the prescription tracking bill was put together after lawmakers heard that prosecutors planned to go after doctors who were prescribing painkillers for pain, and saw how it could be used to target residents otherwise.
The health privacy bill came out of legislators’ fear that patient data could be leveraged by other states or the federal government in order to prosecute people for getting care that’s legal in Illinois. Last May, suburban Mount Prospect’s police department was probed by the state for sharing license plate reader data with Texas police tracking a woman whose family alleged she had a self-administered abortion.
The Department of Justice has also issued more than 20 subpoenas for patient data regarding their gender-affirming care; no charges were announced, but the impact had a chilling effect.
“Everything we do is constantly watching the horizon, listening for context clues of what they’re going to do next, and then reverse engineering how to protect against that,” Cassidy said. “Sometimes we have to knit stuff together like that to catch as much as we can. … It’s a constant game of Whac-a-Mole.”
An adjacent piece of legislation would require insurance providers to cover at least six months’ supply of estrogen prescriptions starting in 2028. Senate debates reduced the original yearlong requirement to half of that, and testosterone couldn’t be included since it’s federally marked as a Schedule III drug.
It’s the latest in an ongoing search for ways in which the state could supersede a federal ban on gender-affirming care after one such attempt which was struck down in federal court earlier this year.
One of the bill’s sponsors, Rep. Katie Stuart, said she was disappointed to not get the 12-month proposal through but was glad that constituents facing stigma for their hormone therapy and menopause prescriptions would be able to get more of their medications.
“Ultimately, my bill is an insurance bill,” said Stuart, D-Edwardsville. “A medical doctor prescribed it, it’s the right care for the patient, and we fight this battle all the time because the insurance is supposed to pay.”
The fourth bill creates a framework for planning when foster care youth are moved out of state.
For trans youth, moving to a foster home out of state currently means they have no voice in a decision that could cut them off from their medicine. When the bill is signed into law, the state will dedicate workers to keeping in touch with kids after they move and appoint counsel for youth at risk of being deprived of healthcare.
“If there’s reason to place a kid out of state, a family placement or congregate care, there’s also an obligation on the state as that stand-in parent to have a plan for that kid’s care,” Cassidy said.
For Cassidy, there’s more work to do. She still wants to expand data privacy laws, specifically around medical data, and hopes to make the name change process easier and cheaper. She wants to return to those issues in the fall.
“The idea of living in this world right now, constantly vulnerable to a document check, is something that gives me nightmares,” Cassidy said. “So we need to get that across the finish line and get rid of those hurdles.”