Insurance plans could soon be required to cover hippotherapy in Illinois
[June 12, 2025]
By Jade Aubrey and UIS Public Affairs Reporting (PAR)
SPRINGFIELD – Under a bill awaiting the governor’s signature, certain
insurance plans would have to cover hippotherapy and other forms of
therapeutic horseback riding in Illinois.
Hippotherapy is a type of physical, occupational and speech therapy
where the movement of a horse is used to treat a patient’s specific
disability or disorder. The practice is used to treat conditions such as
autism, cerebral palsy, arthritis, multiple sclerosis, strokes, head and
spinal cord injuries, as well as behavioral disorders and psychiatric
disorders, including PTSD.
Marita Wassman is the founder of Ride On St. Louis, a nonprofit
organization that provides equine-assisted services to both children and
adults in the St. Louis area. As one of five licensed certified
therapeutic riding instructors at the advanced level in Missouri,
Wassman’s stable has provided services to patients for over 27 years –
the majority of whom she says are children needing physical or
intellectual services.
A previous patient of hers was an 8-year-old girl with cerebral palsy
who struggled to hold her head upright on her own for extended periods
of time. After four months of treatment, Wassman said the girl’s parents
reported that she was able to both sit and hold her head up for over an
hour when they went out to dinner – when previously, she would rest her
head on her arms for a majority of the dinner.
“If you were to go ride a horse for an hour, it could benefit you
exactly the same way as if you did a powerwalk for an hour,” Wassman
said. “And for people specifically who can’t get that on their own, who
are in wheelchairs or even if they are ambulatory but don’t have a
symmetrical movement, sitting on a horse that is nice and even is really
going to help their muscles.”
During sessions, a licensed therapist typically works alongside a horse
handler, who confer with each other beforehand about the patient’s goals
and the variables that would affect the session – like the breed of the
horse and the activities that would be most beneficial to the patient.
“Horses movements are very different – you can have a horse that makes
your hips and your pelvis have a lot more anterior and posterior
movement, or forwards and backwards movement, or some of them are going
to deliver more lateral movement,” Wassman said. “So, if you’re working
with a person with cerebral palsy who is weak in their spine and they
need to develop their anterior and posterior muscles more, you’re going
to want to make sure they’re on a horse that has a movement that is more
front and back.”
Beyond horseback riding, Wassman said there are a variety of other
factors that make the practice effective. For some patients, being
outside and partaking in a shared experience surrounded by supportive
professionals can be emotionally uplifting, which she said may provide a
sense of engagement and community.
Another aspect of the services sometimes involves overcoming fear for
patients with anxiety, Wassman said. Since horses are large,
intimidating creatures, overcoming a fear of the horse as well as
engaging in and developing skills related to riding can help specific
patients with self-esteem.
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A measure awaiting Gov. JB Pritzker would mandate that certain
insurance plans cover hippotherapy and other therapeutic horseback
riding treatments. (photo by Philippe Oursel via Unsplash)
Equine-assisted service specialists like Wassman also report that horses
seem to have a calming effect on patients, which Wassman attributes to
their heart rates. Because they’re such large animals, horses have lower
heart rates than humans, which she said soothes both humans and animals
near a horse.
“A lot of times people’s breathing will kind of relax or slow down when
they’re near or around the horses,” she said.
Some patients may not ride a horse but instead will simply interact with
one during their session, she said. Occupational therapists may choose
to treat a patient’s physical mobility by brushing a horse, especially
when other forms of typical treatment aren’t working.
“It’s kind of like baking,” Wassman said. “When you’re baking, you use
flour, sugar, salt, water, milk or whatever in so many of your baking
recipes, but you don’t know what the outcome is going to be unless you
specifically have your recipe. You could make pancakes, you could make
crispy cookies, you could make chewy chocolate chips cookies, or
whatever.
“It’s the same thing with equine-assisted services – what specific goals
and objectives you have for each of those specific riders breaks down to
your lesson plans and your treatment plans and everything that you’re
writing to try help that person.”
She told another previous patient’s story – one who quickly attained
results after previously making little progress in traditional therapy
settings.
“The patient’s mother goes, ‘We did eight years of physical therapy.
Then we came and started doing physical therapy on horseback, and we
achieved so much more in six weeks than in eight years.’” Wassman said.
Wassman said the insurance aspect of equine-assisted services has always
been a point of contention for stables and therapists in the past, as
some insurance companies have fought compensating therapists for their
hippotherapy services. At stables where other services are offered, she
said patients and their parents can often get confused about what
services insurance will and won’t cover.
“For services that are not involved with an occupational or physical
therapist, speech therapist, or mental health professional, you cannot
bill insurance,” she said. “There’s a lot of stables out there that
don’t employ therapists but still provide services.”
Senate Bill 69 passed the Senate unanimously in April as well as the
House in late May on a vote of 78-33. It will become law if signed by
Gov. JB Pritzker.
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