Healthcare

passed · Massachusetts · House Sep 18, 2025

H 1133: An Act relative to patient financial protection

This bill requires most health insurance plans in Massachusetts to set a separate yearly maximum out-of-pocket limit specifically for prescription drugs (including specialty drugs). This limit cannot exceed the federal minimum annual deductible for high-deductible health plans (as defined in the Internal Revenue Code). It applies to all policies covering prescription drugs delivered, issued, or renewed after January 1, 2025, directly affecting patients who use prescription medications. The limit includes standard drug costs like copays and coinsurance, as defined under federal law.

Topics ✓ HealthcareSupports HealthcareBill establishes out-of-pocket limits for prescription drugs, reducing patient financial burden and protecting access to medications under insurance coverage.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Dec 8, 2025

S 1409: An Act to reform mental health supports and increase public safety

This bill (SD 1718) requires mandatory psychiatric evaluations in hospital emergency rooms when a physician, psychologist, advanced practice nurse, or social worker authorizes a restraint for a patient. It directly affects individuals experiencing mental health crises who are placed under restraint in emergency settings. The key provision mandates that the emergency room, not other facilities, must determine whether to seek a 3-day hospitalization at a public or department-approved private facility. This change aims to standardize emergency mental health assessments and hospitalization decisions.

Topics ✓ Criminal JusticeSupports Criminal JusticeMandates psychiatric evaluations during ER restraints, diverting mental health crises from criminal justice system to appropriate care, aligning with reform goals.85% confidence ✓ HealthcareSupports HealthcareMandates psychiatric evaluations in ERs for restraint cases, directly strengthening mental health access and safety protocols within healthcare services.95% confidence

Sub-Topics Hospitals Mental Health Substance Abuse

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passed · Massachusetts · Senate Jan 7, 2026

S 1626: An Act to protect essential health services

S 1626, sponsored by Senator Bruce Tarr, aims to protect essential health services under Public Health legislation. The bill seeks to establish safeguards for critical healthcare services but lacks specific details in the provided abstract about which services or how protections would be implemented. Without additional context on its provisions or affected populations, this summary reflects only the bill's stated purpose as described in its title and abstract. The abstract does not specify mechanisms, affected groups, or concrete policy changes.

Topics ✓ HealthcareSupports HealthcareBill title explicitly aims to protect essential health services, directly aligning with support indicators like safeguarding critical care under public health legislation.95% confidence

Sub-Topics Public Health

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passed · Massachusetts · House Jan 28, 2026

H 1299: An Act to increase enrollment in affordable health plan networks

This bill (HD 3215) modifies Massachusetts health insurance regulations to increase enrollment in affordable health plan networks. It creates exemptions for insurance carriers if most members are in single-rate regions, subsidized coverage (Chapter 176Q), or if 80%+ income comes from government programs. The bill also requires carriers to include entire provider groups in networks on an "all-or-nothing" basis, rather than selectively adding providers to select or tiered networks. These changes primarily affect health insurance carriers operating in Massachusetts, aiming to simplify network requirements for certain plans and improve access to providers for enrollees.

Topics ✓ HealthcareSupports HealthcareBill explicitly aims to increase enrollment in affordable health plan networks, directly expanding access to healthcare coverage.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Mar 12, 2026

H 1246: An Act establishing a public health option

By Representative Lewis of Framingham, a petition (accompanied by bill, House, No. 1246) of Jack Patrick Lewis that the Commonwealth Connector Authority provide for a public health insurance option. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill establishes a public health insurance option to expand coverage through Commonwealth Connector Authority, directly advancing healthcare access and funding.95% confidence

Sub-Topics Insurance Public Health

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passed · Massachusetts · House Jan 28, 2026

H 1313: An Act relating to patient choice in dispensing of clinician-administered drugs

This bill (HD 2922) ensures patients have choice when receiving certain outpatient drugs that require clinical administration (like IV treatments), directly affecting patients and healthcare providers. It prohibits health insurance companies from refusing payment, charging extra fees, or penalizing patients when they choose to get these drugs from their preferred provider (e.g., a doctor's office) or pharmacy - not just a plan-selected pharmacy. The law also blocks insurers from steering patients toward specific pharmacies or requiring specialty pharmacies to deliver drugs directly to patients for later administration by a provider. Insurance companies may offer home infusion options but cannot mandate them. This creates a clear standard for coverage without extra costs for patient-selected care.

Topics ✓ HealthcareSupports HealthcareBill promotes patient autonomy in drug dispensing, enhancing access to clinician-administered treatments without restricting options or coverage.90% confidence

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passed · Massachusetts · House Jan 28, 2026

H 1240: An Act relative to insulin access

This bill caps out-of-pocket insulin costs at $100 per 30-day supply for all patients, regardless of insulin type or quantity needed. It directly affects insulin users, drug manufacturers, and insurers by requiring them to limit patient costs. Drug companies must offer free 30-day insulin supplies to eligible individuals urgently needing insulin (with less than a 7-day supply) who meet income limits (≤400% federal poverty level) and lack private drug coverage. The law also mandates manufacturers to establish accessible application processes for this assistance program within 14 days.

Topics ✓ HealthcareSupports HealthcareBill directly addresses insulin access, improving patient access to essential medication and aligning with healthcare support indicators.95% confidence

Sub-Topics Prescription Drugs

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passed · Massachusetts · House Mar 12, 2026

H 1241: An Act relative to fair access for qualifying patients

HD 115 (An Act relative to fair access for qualifying patients) requires health insurance plans regulated in Massachusetts to reimburse healthcare providers who certify patients for medical cannabis use under Chapter 94I. It also allows these plans to include medical cannabis in their coverage formularies, provided it is listed on specific schedules within the state's Drug Control Program. This bill directly affects medical cannabis patients and healthcare providers who certify their use, as it creates a reimbursement pathway and expands coverage options. The key mechanism ensures providers can be paid for certifications and gives plans the option to cover cannabis as a medical treatment, subject to state drug scheduling rules.

Topics ✓ HealthcareSupports HealthcareBill ensures reimbursement eligibility for qualifying patients, expanding access to health plans and improving coverage under healthcare access policies.90% confidence

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passed · Massachusetts · House Mar 12, 2026

H 1192: An Act for health care non-discrimination

By Representative Honan of Boston, a petition (accompanied by bill, House, No. 1192) of Kevin G. Honan relative to establishing alternative payment arrangements to promote health care non-discrimination. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill promotes healthcare non-discrimination via alternative payment arrangements, directly aligning with protecting patient rights and access under healthcare policy indicators.95% confidence

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passed · Massachusetts · House May 11, 2026

H 1188: An Act relative to trans-inclusive health care access

This bill, HD 1500, requires health insurance providers, health care plans, and related entities to accept a single written verification from a health care provider for gender-affirming care. It prohibits them from rejecting such verification unless it clearly fails to meet established clinical guidelines, and prevents them from demanding more than one verification for treatment of gender dysphoria. The bill defines "qualified mental health care professional" using standards from the World Professional Association for Transgender Health (WPATH). It directly affects transgender individuals seeking health coverage for gender-affirming care and the insurers/health plans that process those requests. The policy change removes bureaucratic barriers to accessing medically necessary care.

Topics ✓ HealthcareSupports HealthcareBill explicitly seeks healthcare coverage for gender affirming care, expanding access to a specific health service within the healthcare topic.95% confidence

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