Illinois said it was fixing therapy access. It just blew up your insurance bill

Illinois has identified a real problem in behavioral healthcare: some people with commercial insurance struggle to find in-network care, while some providers say low reimbursement discourages them from joining insurance networks. Those problems deserve attention. But recognizing a problem does not mean policymakers know the right solution.Illinois has chosen to mandate one.In December 2025, Gov. JB Pritzker (D-IL) signed legislation establishing one of the nation’s first statutory reimbursement floors for commercial mental health and substance use disorder care. Effective Jan. 1, 2027, insurers operating in Illinois will be required to pay behavioral healthcare providers at a statutory floor corresponding to 141.7% of the Medicare rate for covered services under many regulated commercial plans. The National Association of Social Workers’ IL Chapter reports that roughly 2.5 million Illinoisans are on these plans. No credible estimate appears to be publicly available for the additional annual insurer claims spending. NASW-IL reports that a DuPage County Health Department executive estimates that the law will help generate “hundreds of millions of dollars” in new provider revenue annually. For a 60-minute psychotherapy session, for example, Chicago healthcare billing firm Neolytix estimates that the statutory floor would be around $236.60 using 2026 rates, compared with current Blue Cross and Blue Shield of Illinois reimbursement of $115 to $160 for master’s-level clinicians. A mandate that increases insurers’ expected claims costs will have to come from somewhere. How each insurer responds is impossible to predict: higher premiums, narrower networks, utilization management, or something else. But the underlying economic reality is not: Illinoisans will ultimately bear the cost in one form or another. Those harms may be diffuse, delayed, or difficult to observe, but they are real.Supporters argue that higher reimbursement will encourage more providers to participate in insurance networks and therefore improve access. That sounds straightforward. But healthcare prices are not arbitrary numbers waiting for policymakers to correct. They are signals.The negotiated reimbursement rates between these commercial health plans and their behavioral healthcare providers communicate information that policymakers can’t observe, such as relative scarcity and competing demands, and they give market participants incentives to respond to that information. When government overrides those prices, it does more than raise a number. It changes the information and incentives embedded in the market.That does not mean existing rates are necessarily optimal. But discovering that a price is associated with an undesirable outcome does not establish that policymakers should set a price floor. The policy risks treating the price as the problem rather than asking what it reveals about the underlying conditions. Changing the price does not necessarily change those conditions — and may make it harder to determine which barriers are actually limiting access.Mandating higher reimbursement will change provider incentives in the state. For example, some providers may shift more of their patient panels toward commercially insured patients because of the higher rates, reducing availability for Medicaid beneficiaries. The effects of changing one price, however, will not necessarily stop with the providers and insurers directly affected by the mandate.Policymakers do not possess enough information to determine the reimbursement rate that will produce the best allocation of scarce behavioral health resources. Providers, patients, and insurers possess pieces of that information and have incentives to discover better arrangements through decentralized decision-making.More fundamentally, the policy moves the behavioral healthcare market further away from addressing the barriers that keep care scarce, expensive, and difficult for patients to navigate. Instead of removing those barriers, it entrenches the existing system with another regulatory intervention.OPINION: TRUMP IS RIGHT TO INVESTIGATE GERMANY — AND HE SHOULDN’T STOP THEREIllinois policymakers should repeal the reimbursement floor before it takes effect on Jan. 1, 2027, and other states should resist enacting similar legislation. The goal should not be to find the politically preferred price for behavioral healthcare. It should be to give patients, providers, and insurers greater freedom to discover better prices, better services, and better ways of delivering care.Patrick N. Dempsey holds a Master of Public Health from Yale University, is a former Boston Consulting Group healthcare services consulting analyst, and is a volunteer crisis counselor and suicide grief support facilitator.