Illinois - AOPA

ENACTED

Illinois SB-2195

Bill Number:

SB 2195 / HB 3036

Status:

Enacted

Date Signed Into Law:

8/7/2023

Date Law Goes Into Effect:

1/1/2025

Insurance Plans Affected:

State Commercial Plans

Age Group:

All Ages

Types of Devices Covered:

Orthoses + Prostheses

State Lead:

Jim Kaiser, CP

Primary Bill Sponsors:

Sen. Ann Gillespie, Sen. Laura Fine, Rep. Will Guzzardi, Rep. Laura Faver Dias, Rep. Mary Beth Canty

Contact Your Representative

At a Glance

Illinois Statistics

Physical activity is one of the most important factors in maintaining overall health throughout one’s lifetime. Whether it’s vigorous exercise or simple day-to-day movement, being physically active increases strength and balance, improves mental health, supports better-quality sleep, and reduces the risk of disease and cancer for every body, including people with disabilities.

4.5X

Children with disabilities are 4.5 times less likely to engage in physical activity compared to their peers.

American College of Sports Medicine, Why We Must Prioritize Equitable Access to Physical Activity for Children with Disabilities

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1 in 2

50% of adults with disabilities get absolutely no aerobic physical activity.

Centers for Disease Control and Prevention (CDC), Inactivity Related to Chronic Disease in Adults with Disabilities

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Adults and children with mobility limitations are at greatest risk for obesity and the prevalence of obesity in children with disabilities is almost twice that of children without disabilities.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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60 / 150 Mins

The U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans recommends children with disabilities get 60 or more minutes each day of moderate or vigorous intensity aerobic physical activity; for adults with disabilities, the recommendation is 150 minutes weekly.

U.S. Department of Health and Human Services, Physical Activity Guidelines for Americans, 2nd Edition

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$44 Billion

Annual health care costs of obesity that are related to disability are estimated at approximately $44 billion.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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“F”

According to the 2022 U.S. Report Card on Physical Activity for Children and Youth, the U.S. received an “F” grade for children with disabilities, with less than 17.5% meeting the recommended daily physical activity.

Physical Activity Alliance, The 2022 United States Report Card on Physical Activity for Children and Youth

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Prior to the enactment of SB-2195, the majority of Illinoisans with limb loss, limb difference, and mobility impairment faced difficulties in obtaining affordable and accessible prosthetic and orthotic care for physical activities and exercise because state, federal, and private health plans deem this care “not medically necessary.”

Without health plan coverage, adults, children, and families are forced to:

Incur prohibitive out-of-pocket costs (ranging from $5,000 -$50,000)
Risk harm/injury using an improper device
Live socially isolated and sedentary lifestyles with costly health complications including obesity and depression

SB-2195 will now ensure Illinoisans with disabilities that are covered by state-regulated commercial insurance plans have access to all facets of society including physical activity and exercise through coverage of recreational prostheses and orthoses. Help us get the word out and maximize the positive impact of this new law for the disability community in Illinois!

What does SB-2195 do?

This bill amends Illinois’ previous prosthetic & orthotic coverage law (enacted in 2009) so state-regulated commercial insurance plans are required to cover an additional prosthetic and orthotic device necessary for physical activity.

How SB-2195 Benefits Illinois

“We have the technology that allows children and adults with limb loss or limb difference to play outside, participate in sports and pursue their goals without limitations. But without the help of insurance, these prosthetics and orthotics are often too costly for many individuals and families,” said State Sen. Ann Gillespie (D-Arlington Heights). “By expanding what is considered medically necessary – which living an active, healthy lifestyle is – we are breaking down barriers and empowering individuals to embrace their full potential.”

Inspiring Narratives from Illinois

“The signing of SB 2195 into law is a great day in the limb loss, limb difference and limb impairment community,” said Allie Johnson, Paralympian 2022 Beijing Winter Olympics. “Access to sport has been so life changing for me and I can’t wait to see more amputees and limb difference/impaired individuals trying new things and breaking down barriers!”

Allie Johnson

Western Springs, IL

Allie Johnson

Western Springs, IL