Healthcare (Insurance)

passed · Massachusetts · House Jan 23, 2026

H 1237: An Act to further enhance rate review examinations conducted by the health care access bureau within the division of insurance

This bill establishes a Health Care Access Bureau within Massachusetts' Division of Insurance, led by a deputy commissioner, to conduct enhanced rate reviews of health insurance premiums. The bureau must evaluate rates for affordability - considering consumer costs like deductibles and copays, as well as impacts on state health care spending goals - and examine causes of premium increases and provider price variations. Insurers licensed in Massachusetts will pay an annual $2 million assessment to fund the bureau's operations, with additional funds allocated for General Fund costs. The bureau's work aims to protect consumers, improve access to affordable coverage, and ensure fair treatment for health care providers.

Topics ✓ HealthcareSupports HealthcareEnhances rate review oversight for health insurance markets, strengthening consumer protections and market transparency in healthcare access.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Jan 23, 2026

H 1181: An Act to redirect excessive health insurer reserves to support health care safety net programs

This bill requires health insurance companies with reserves exceeding 550% of risk-based capital to pay an assessment generating $400 million in 2023. The funds will be split equally: $200 million to the Health Safety Net Trust Fund (supporting community health programs) and $200 million to the Medicaid Stabilization Trust Fund (to prevent cuts in MassHealth services and provider reimbursements). The assessment applies only to insurers meeting the reserve threshold and expires on December 31, 2026. It directly affects health insurers with significant excess reserves, redirecting those funds to stabilize healthcare access for low-income residents.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill imposes insurance assessment to fund healthcare safety net programs, directly increasing public service funding via new revenue source.95% confidence ✓ HealthcareSupports HealthcareRedirects insurer reserves to fund healthcare safety net programs, increasing public health funding and support for service delivery.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Jan 23, 2026

H 1238: An Act establishing a division of health insurance

This bill (HD 4031) renames multiple state departments and divisions to replace "insurance" with "health insurance" in official titles and responsibilities. It updates terms across 26 sections of law, including renaming the "Division of Insurance" to "Division of Health Insurance" and the "Commissioner of Insurance" to "Commissioner of Health Insurance" in relevant statutes. The bill directly affects the Department of Consumer Affairs and Business Regulation, its divisions, and state agencies overseeing health insurance oversight. It makes no new policy changes but ensures consistent terminology for health insurance regulation within state law.

Topics ✓ HealthcareSupports HealthcareEstablishing a division of health insurance structurally supports healthcare administration by creating dedicated oversight, aligning with strengthening system management.75% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Jan 29, 2026

S 2600: An Act requiring health insurance coverage for scalp cooling systems

By Mr. Rush, a petition (accompanied by bill, Senate, No. 2600) (subject to Joint Rule 12) of Michael F. Rush for legislation to require health insurance coverage for scalp cooling systems. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill mandates health insurance coverage for scalp cooling systems, expanding patient access to cancer treatment support.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Feb 5, 2026

H 1257: An Act relative to ensuring treatment for genetic craniofacial conditions

This bill (HD 1173) requires specific insurance plans in Massachusetts to cover medically necessary functional repair or restoration for certain congenital craniofacial disorders. It applies to Commonwealth employee health plans, state division programs, private insurance policies, and health maintenance organizations. Coverage must include treatment for ectodermal dysplasia, dentinogenesis imperfecta, and amelogenesis imperfecta (excluding cleft lip/palate, which is covered under separate existing sections), but excludes cosmetic surgery and unrelated dental/orthodontic care. Crucially, these benefits must not face higher deductibles, copays, or out-of-pocket limits than other plan benefits.

Topics ✓ HealthcareSupports HealthcareBill mandates health insurance coverage for genetic craniofacial treatment, expanding patient access to specialized care.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Jan 29, 2026

S 822: An Act expanding health insurance access for state employees

By Ms. Rausch, a petition (accompanied by bill, Senate, No. 822) of Rebecca L. Rausch for legislation to expand health insurance access for state employees. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill explicitly expands health insurance access for state employees, directly advancing coverage access per title and summary.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Jan 29, 2026

S 908: An Act establishing a healthcare insurance premium payment pool for working families

This bill (SD 164) amends a section of state law to allow multiple entities - such as employers, government programs, and policyholders - to collectively use private vendors for collecting health insurance premiums. It does not create new funding or coverage but requires educating employers and insurers about existing private collection services. The bill directly affects employers, insurers, and government programs that pay for health insurance, not working families as the title suggests. It is a procedural change focused on administrative efficiency, not substantive policy.

Topics ✓ HealthcareSupports HealthcareEstablishes premium payment pool to make healthcare insurance affordable for working families, directly expanding coverage access and reducing out-of-pocket costs.95% confidence

Sub-Topics Insurance

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in committee · Massachusetts · House Jun 17, 2026

H 4342: An Act assuring prompt access to health care

H 4342 requires most health insurance plans in Massachusetts to cover routine outpatient doctor visits and basic medical care without requiring patients to pay a deductible first. This applies to standard individual, group, and employer-sponsored health insurance plans sold within the state. Certain federal tax-exempt health plans may still require deductibles to maintain their tax status. The law aims to reduce upfront costs for common medical services like check-ups and minor treatments.

Topics ✓ HealthcareSupports HealthcareMandates no deductibles for routine care, reducing patient costs and improving access to basic medical services like check-ups.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · Senate Jan 29, 2026

S 695: An Act promoting consumer choice in health care

By Mr. Crighton, a petition (accompanied by bill, Senate, No. 695) of Brendan P. Crighton for legislation relative to health insurance coverage by athletic trainers. Financial Services.

Topics ✓ HealthcareSupports HealthcareBill expands health insurance coverage for athletic trainers' services, promoting consumer choice in healthcare access as a support indicator.85% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Jan 22, 2026

H 1165: An Act providing for certain health insurance coverage

This bill requires all health insurance plans in Massachusetts - including those covering state employees, group plans, and individual policies - to cover the cost of specialized medical formulas (for home use, administered orally or via tube feeding) when prescribed by a doctor for specific serious conditions. It applies to policies governed by Massachusetts law, including group insurance, hospital service plans, and medical service agreements. Coverage is limited to formulas proven effective for conditions like inherited metabolic disorders, Crohn's disease, or severe food allergies, as documented by a physician's written order stating medical necessity. The bill explicitly distinguishes these medically required formulas from general nutritional supplements taken without a medical need.

Topics ✓ HealthcareSupports HealthcareBill explicitly aims to provide health insurance coverage, advancing patient access to healthcare services.95% confidence

Sub-Topics Insurance

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