Governor JB Pritzker Signs Legislation Capping Prescription Asthma Inhaler and Insulin Copays at $25

SPRINGFIELD, Ill. — Governor JB Pritzker signed House Bill 2418 into law on Monday, establishing statutory out-of-pocket cost caps of $25 per 30-day supply for prescription asthma rescue inhalers and maintenance medications across all state-regulated commercial health insurance plans.

The statute builds upon Illinois's landmark 2020 insulin price cap, making Illinois the first state in the Midwest to enact comprehensive copay limits for respiratory medications while lowering the state's commercial insulin copay ceiling from $35 down to $25 per month.

Protecting Over 850,000 Illinois Residents Living with Asthma Public health data reveals that over 850,000 Illinois residents, including 170,000 children, live with asthma. Retail out-of-pocket prices for generic and brand-name inhalers frequently exceed $300 per canister, forcing patients to ration doses and resulting in preventable emergency room visits.

"No parent should ever have to choose between putting groceries on the table and buying the inhaler their child needs to breathe," Governor Pritzker said during a bill signing at the University of Illinois Chicago Health Sciences Campus. "Big pharmaceutical companies have made billions marking up century-old medicines that cost less than five dollars to manufacture. This new law puts an end to price gouging, guaranteeing that every Illinois family can access life-saving respiratory and diabetes medication for no more than $25 a month."

Insurance Regulation and PBM Transparency Under House Bill 2418:

• $25 Copay Maximum: Prohibiting insurers from applying deductibles, co-insurance percentages, or prior authorization tiering that results in patient costs exceeding $25 per prescription.
• Pharmacy Benefit Manager (PBM) Audits: Directing the Illinois Department of Insurance to audit PBM rebate pass-through compliance.
• Price Protection on Multiple Delivery Devices: Applying the $25 cap to dry-powder inhalers, metered-dose canisters, and nebulizer solutions.

Physician associations, respiratory disease foundations, and patient advocacy coalitions praised the legislation, noting that removing cost barriers to maintenance inhalers dramatically reduces acute pediatric emergency room admissions.