A host of bills mandating health care coverage, regulating pharmaceutical practices and targeting specific health issues go into effect in Illinois for 2026, many on the first day of the year. [Crains]

With one major piece of legislation passed in 2025, the Prescription Drug Affordability Act, Illinois joins numerous other states that have taken aim at the practices of pharmacy benefit managers.

The act will forbid pharmacy benefit managers — or PBMs — from steering people to specific pharmacies or companies; limiting access to a covered drug by designating it a specialty drug, contrary to the drug's definition; and engaging in spread pricing, the practice of charging insurance plans more than they reimburse pharmacies for and keeping the difference.

In addition, the law levies a fee, per covered member, on PBMs that will be used to fund up to $25 million a year in grants to independent pharmacies and pharmacies located in rural counties, medically underserved areas, low-income communities and pharmacies that serve high concentrations of Medicaid patients.

Coverage considerations

Each year, Illinois legislators find specific health conditions, drugs and therapies they want to ensure can't be carved out of health coverage. The 2025 General Assembly sessions was no exception.

Health insurers will now have to ensure that when a patient receives neonatal intensive care at a nonparticipating provider or nonparticipating facility, the beneficiary, insured or enrollee will not incur greater out-of-pocket costs than he or she would have incurred with a participating provider or a participating facility, as long as the nonparticipating provider or nonparticipating facility bills the neonatal intensive care as emergency services.

Health plans must provide coverage, no less than once every 12 months, for a peripheral artery disease screening test for any at-risk individual.

Health maintenance organizations will be required to cover certain at-home pregnancy tests and certain medically necessary treatments to address a major injury to the jaw.

And starting on Jan. 1, 2027, insurers must also provide continuity of care for beneficiaries, in that a network plan shall permit the beneficiary to continue an ongoing course of treatment with that provider during a transitional period for 90 days after notifying a beneficiary that a provider is pulling out of a network plan.

Also starting in 2027, health insurers must cover medically necessary diagnostic testing and FDA-approved treatments or medications prescribed to slow the progression of Alzheimer’s disease or another related dementia. They also must cover medically necessary horse-riding therapy or services that "incorporate equine movement as part of a therapeutic intervention."

And in 2027, insurers must find non-opioid pain medications. Health insurers must develop a plan to provide adequate coverage and access to a broad spectrum of pain management services, including, but not limited to, non-opioid, non-narcotic pain management services and non-medication pain management that serve as alternatives to the prescribing of opioid or narcotic drugs in accordance with guidelines developed by the state Department of Insurance.

Health plans must also tell their enrollees about these laws. Each year, health plans must provide, upon request, a statement of all basic health care services and all specific benefits and services mandated to be provided to enrollees by state law or administrative rule, highlighting any newly enacted state law or administrative rule.

Emergency, and not so emergency, services

In 2026, all 911 telecommunicators who are dispatching emergency services must be trained in "high-quality telecommunicator cardiopulmonary resuscitation (T-CPR)." The training would instruct 911 dispatchers on how to talk a caller through providing CPR.

People who, acting in good faith, administer an epinephrine delivery system in an emergency will not be liable for civil damages to a person who was given the epinephrine shot, except for in the case of willful and wanton misconduct.

Fire departments and fire protection districts may now begin charging nursing homes and assisted living facilities for nonemergency lift-assist services — calls to lift a patient into a bed, for instance — after the sixth time safety employees are called to a location in a year.

The state is taking a cue from Chicago by mandating the opioid overdose medication naloxone be made available at all public libraries across the state, and requiring at least one staff member be trained to identify overdoses and to administer the drug, typically a nasal spray.

The Office of the State Fire Marshal will begin tracking the manner of death for all firefighters in Illinois, including suicide and types of cancer.

Employers will have to allow part-time employees, as well as full-timers, to use up to 10 days of leave in any 12-month period to serve as an organ donor. It also provides that, for a part-time worker using leave to serve as an organ donor, the employer has to calculate their daily average pay during the previous two months and compensate them with that average for the leave days used.

The Illinois Department of Human Services' Office to Prevent & End Homelessness will begin to maintain a website on how a hospital or health care provider may connect a patient with a homeless shelter or homeless support services. The law taking effect Jan. 1 also requires the department to include on its website a way for the hospital or provider to determine which continuum of care applies, based on the facility's physical location.

Beyond health care, the Illinois Municipal League provides a comprehensive list of all kinds of state legislation "of municipal interest" that take effect in 2026 and 2027.

Check out IOMC's Upcoming Programs: 

1.14.2026  Webinar: From Awareness to Action: Increasing HPV Vaccine Referrals in Dental Settings. More details and to Register> 

2.17.2026 Webinar: Addressing the Health Needs of Justice Involved Individuals during Reentry. More details and to Register> 

Sponsors: Interested in sponsoring a webinar or program? Contact us at sponsorship@iomc.org. 

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An aging nation. A post-pandemic rebound for the entertainment industry. Young adults delayed traditional milestones. Homebuyers faced higher mortgage payments. Childlessness rose— except among older women. Only Hispanic households experienced significant increase in median income. [United States Census Bureau]

These were just a few of the changes our nation experienced, according to U.S. Census Bureau data and research released in 2025. Here we recap some key trends and findings by topic through a selection of America Counts stories published this year.

Employment 

Housing 

Aging Population 

And more

More>

Influenza activity in the United States has spiked across the country, with 17 jurisdictions (14 states and Puerto Rico; Washington, DC; and New York City) reporting high or very high influenza-like illness (ILI) and other key indicators rising markedly, signaling the start of the flu season in earnest, the Centers for Disease Control and Prevention (CDC) said today in its weekly FluView update.. [KFF Health News]

The CDC also noted two new flu-related deaths in children and provided data on the rise of subclade K among H3N2 flu viruses as Americans approach the peak season of gathering with family and friends.

The number of jurisdictions with high or very high ILI cases for the week ending December 13 is up from five the previous week, the CDC said. In addition, the percentage of respiratory viruses that tested positive for flu rose from 8.1% to 14.8%, and the rate of visits to clinics (outpatient visits) for respiratory illness rose from 3.2% to 4.1%, well above the national baseline of 3.1% (see CDC epidemiologic curve below).

Subclade K now prevalent

“Sustained elevated activity is observed across multiple key activity indicators in many areas of the country, signaling the start of the 2025-2026 influenza season,” the CDC noted. “Severity indicators remain low at this time, but influenza activity is expected to continue for weeks.”

The agency noted that 911 of 927 influenza viruses reported by public health labs were influenza A, with 16 being influenza B. Of 706 influenza A viruses subtyped, 10.1% were the H1N1 strain, and 89.9% were H3N2. Notably, among 216 H3N2 viruses collected since September 28 that underwent additional genetic characterization by CDC scientists, 89.8% belonged to subclade K, the subclade that is predominating in multiple countries and raising concerns about a possible mismatch with the seasonal flu vaccine.

The weekly hospitalization rate for respiratory illness reached 14.3 per 100,000 residents, up from 6.6 the week before. Almost 10,000 patients were admitted to hospitals for influenza last week. Deaths attributed to flu rose slightly, from 0.2% to 0.3%.

Both flu-related pediatric deaths were tied to H3 strains. One occurred in November and one last week. The CDC has now confirmed three deaths in children this year, after 2024-25 saw 288 over the entire season.

More>

PHILADELPHIA — Leon Harris, 35, is intimately familiar with the devastation guns can inflict. Robbers shot him in the back nearly two decades ago, leaving him paralyzed from the chest down. The bullet remains lodged in his spine. [KFF health News]

This story also ran on USA Today. It can be republished for free.

Help Us Investigate Medical Care for Gunshot Wounds

We’d like to talk to people who’ve been wounded or families of those killed by gun violence to better understand how insurance affects such medical care.

Read More

“When you get shot,” he said, “you stop thinking about the future.”

He is anchored by his wife and child and faith. He once wanted to work as a forklift driver but has built a stable career in information technology. He finds camaraderie with other gunshot survivors and in advocacy.

Still, trauma remains lodged in his daily life. As gun violence surged in the shadows of the covid pandemic, it shook Harris’ fragile sense of security. He moved his family out of Philadelphia to a leafy suburb in Delaware. But a nagging fear of crime persists.

Now he is thinking about buying a gun.

Harris is one of tens of thousands of Americans killed or injured each year by gun violence, a public health crisis that escalated in the pandemic and churns a new victim into a hospital emergency room every half hour.

Over the past two decades, the firearm industry has ramped up production and stepped up sales campaigns through social media influencers, conference presentations, and promotions. An industry trade group acknowledged that its traditional customer was “pale, male and stale” and in recent years began targeting Black people and other communities of color who are disproportionately victimized by gun violence.

More>

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The Department of Public Health said Wednesday it will accept guidance from its vaccine committee to recommend that all newborns receive the hepatitis B vaccine at birth. [Health News Illinois]

The adoption comes a day after IDPH’s Immunization Advisory Committee voted to recommend the guidance.

IDPH Director Dr. Sameer Vohra said in a statement that the recommendations will ensure that every newborn in Illinois “receives the strongest protection” against hepatitis B.

“Parents deserve clear, trustworthy, and science-based information when making decisions about their child’s health,” IDPH Director Dr. Sameer Vohra said in a statement. “I am grateful to the (committee) for their thorough review of the latest data, which reaffirms that the hepatitis B vaccine at birth is safe, effective, and critical in preventing chronic liver disease and liver cancer later in life.”

Along with universal hepatitis B vaccination at birth, the recommendations also call for infants to receive all doses of the vaccine on time, and for all pregnant individuals to be screened for hepatitis B in the first trimester or their first prenatal visit.

Members of the state committee said Tuesday they did not see any public health concerns or problems established by the federal vaccine committee to reverse the longtime policy.

The federal Advisory Committee on Immunization Practices voted earlier this month to recommend that no newborns under two months old should receive the vaccine unless deemed at risk, and that the vaccine should only be accepted after conversations with medical professionals.

The Centers for Disease Control and Prevention adopted federal guidance Tuesday evening, saying they support “individual-based decision-making.”

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HOW SUBURBAN COOK COUNTY RESIDENTS USE THE CRISIS CARE SYSTEM

Cook County Department of Public Health conducted surveys and focus groups with suburban Cook County residents in 2024 and 2025.

See the attached report dated November 2025 and published this month> 

BH-Crisis-Response-System-Report-NOV-2025_final_111725_web.pdf

Illinois officials unveiled Monday what they call their first comprehensive look at how Illinoisans use alcohol and its impact on public health. [Health News Illinois]

The analysis from the Department of Public Health found that more than 2,300 deaths statewide between 2020 and 2023 were from causes directly attributable to chronic alcohol use, such as liver disease. An additional 2,000 deaths were “indirectly associated” with chronic alcohol use, including hypertension, coronary heart disease and liver cancer.

Such deaths varied by region. The Peoria region had the highest rate at 5.2 deaths per 100,000 individuals. The greater Chicago region saw a rate of 2.3 deaths per 100,000 individuals.

The report also found a rise in the number of alcohol-related vehicle fatalities. In 2022, the most recent year cited in the report, 37 percent of fatal crashes involved a driver with a blood alcohol concentration of at least .01. Another five percent involved levels between .01 and .07, and 32 percent involved a driver above the legal limit of .08.

The data was compiled from various sources, including several surveys conducted between 2021 and 2023, as well as information compiled by state and federal databases.

The report found that 57 percent of Illinoisans have consumed at least one alcoholic beverage within 30 days of taking part in a survey on their alcohol use. 

More than 18 percent of individuals acknowledged binge drinking, or having at least four drinks within a couple of hours for females, and at least five drinks for males.

Nearly 23 percent of high schoolers have consumed at least one alcoholic beverage in the past 30 days, with more than 11 percent acknowledging they binge drank during that time frame.

Agency Director Dr. Sameer Vohra said the report provides the “most detailed picture to date of how alcohol use and misuse affect the health and safety of Illinois residents.”

“This report serves as a critical foundation for a more informed, coordinated response to the growing public health challenges posed by alcohol misuse across Illinois,” he said.

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As you may know, there has been substantial controversy and negative publicity about the safety of the fluoride and community water fluoridation (CWF) concerning neurodevelopment/IQ over the past 15 months since the publication of the National Toxicology Program's (NTP) "Monograph on the State of the Science Concerning Fluoride Exposure and Neurodevelopment and Cognition: A Systematic Review" and the January 2025 publication of the related meta-analysis by Taylor et al. (2025) in JAMA Pediatrics. IOM-C seminar spaeaker (11/18/25) and UI College of Dentistry Professor Steven Levy also wrote an associated editorial challenging many of their analysis and conclusions (Levy et al., 2025) published in the same journal issue. Virtually all relevant previous publications have been from other countries and/or at much higher F levels than used with CWF. [JAMA Pediatrics et al]

On November 19, 2025, a very important article was published in Science Advances concerning CWF with U.S. data relating fluoride exposures to cognitive test results for a large cohort of high school students followed up at approximately age 60 (Warren et al., 2025). This is a "Game-Changer" since it clearly shows that CWF is not harmful to cognition at the levels used in the United States and is associated with better cognition in adolescence. See the linked article, supplemental material, and important editorial by Dr. Savitz. 

World-recognized epidemiologist, Dr. David Savitz, said in his commentary (2025) that "Until clear evidence exists that water fluoridation lacks public health benefit or compelling evidence of harm at the level of fluoride exposure in fluoridated water, neither of which has occurred, it seems foolhardy to interfere with a long-established and well-recognized public health success. With due credit to the folk wisdom of Bert Lance, director of the Office of Management and Budget under President Jimmy Carter, "If it ain't broke, don't fix it." Warren and colleagues move the needle a bit further into the "ain't broke" range."

Additional information: Science Advances- Warren et al>

Nov.19, 2025 >Warren information>

Savitz information>

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When Su Wang was in medical school, she donated blood. That’s when she learned she was infected with hepatitis B, a virus that attacks the liver and can lead to cancer and death decades later. [KFF Health News]

This story also ran on CBS News. It can be republished for free.

“I was 18, healthy, in college,” she said. “And suddenly I had a chronic illness I didn’t even know about.”

Born in Florida in 1975, Wang grew up before the hepatitis B vaccine was routinely given to newborns. For years, she assumed she had been infected by her mother, only to discover later that both her parents were negative. “It turns out my grandparents, who cared for me after birth, probably passed it to me,” she said. “That’s how easy this virus spreads — not from some exotic risk factor, just family.”

Today, Wang is the medical director for viral hepatitis programs at RWJBarnabas Health in New Jersey. Her story now sits at the center of a historic turning point in public health.

On Dec. 5, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to end the universal U.S. recommendation for the newborn dose of the hepatitis B vaccine, instead adopting a policy urging individual-based decision-making.

Under the new approach, only infants born to mothers who test positive for hepatitis B will automatically receive a dose of the vaccine and hepatitis B antibodies shortly after birth. For everyone else, if the parents choose to vaccinate, the birth dose can be delayed until 2 months of age.

More>