In January 2023, Gov. JB Pritzker signed the Illinois Reproductive Health Act (RHA) into law, granting increased insurance coverage for reproductive health. Among other protections, the RHA provides every pregnant individual the fundamental right to continue with a full-term pregnancy or have an abortion, and make the autonomous decision to exercise this right. 

The Illinois Baptist State Association filed a lawsuit in Sangamon County, Illinois, challenging the protections under the act, asserting that the law violated its religious beliefs because it required it to provide health insurance that includes abortion coverage, which substantially burdened its religious exercise. The Association argued that it was faced with a dilemma: choosing between compliance with the law or violation of its religious beliefs by offering health insurance that provides abortion coverage. 

On Sept. 4, 2024, the Association’s lawsuit was dismissed because the court ruled it could not demonstrate how the RHA substantially burdened its religious exercise; specifically, it could not show how the act compelled it to engage in conduct that directly conflicts with its religious beliefs. The act does not mandate employers to provide certain health insurance coverage; employers may use insurers that do not offer abortion coverage and are not covered by the act. 

These alternative options include federally managed insurers or insurers in other states, which are not subject to the RHA's requirements. The Association decided not to pursue alternative options, and therefore, the court said, the burden on its religious exercise was self-imposed and not an outcome of the RHA requirements. 

Since the enactment of the RHA, Illinois has passed additional laws that have created additional protections for reproductive rights and healthcare. Notably, on Jan. 1, 2025, the Illinois Human Rights Act will expand its definition of unlawful discrimination to include discrimination based on reproductive health decisions, creating a protective class for reproductive health decisions. Employers, especially religious-affiliated entities, should stay tuned for additional changes to the law as Illinois continues to add protections for reproductive rights.