Healthcare

in committee · Massachusetts · House Jul 27, 2026

H 4957: An Act relative to IUD pain management coverage

This bill requires most health insurance plans in Massachusetts to cover pain management during IUD insertion with no out-of-pocket costs for patients. It applies to state employee group insurance (Chapter 32A), Medicaid plans (Chapter 118E), private accident/sickness insurance (Chapter 175), and hospital service plans (Chapter 176A). The law mandates coverage for specific methods like IV sedation, nitrous oxide, or topical anesthesia without deductibles, copays, or unreasonable delays, and extends benefits to covered spouses and dependents. Religious exemptions for church employers are included, requiring written notice to enrollees about excluded services. The bill directly affects insurance providers and enrollees using these coverage types for IUD procedures.

Topics ✓ HealthcareSupports HealthcareMandates no-cost coverage for IUD pain management, expanding access to reproductive healthcare services without financial barriers or delays.95% confidence

Sub-Topics Hospitals Insurance Medicaid

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in committee · Massachusetts · House Jan 7, 2026

H 4881: An Act relative to adjunct faculty in public higher education

This bill requires the state to cover health insurance premiums for qualifying adjunct faculty at public higher education institutions. It defines eligible faculty as those teaching at least two 3-credit courses per semester (or four annually), regardless of funding source or employment term. The state will gradually increase its share of premium costs over five years, starting at 25% in the first year and reaching 75% by the sixth year. A working group must study adjunct faculty retirement benefits, compensation, and career pathways, reporting findings by December 2026. The bill directly affects adjunct faculty at state universities, community colleges, and UMass campuses.

Topics ✓ HealthcareSupports HealthcareBill mandates state funding for adjunct faculty health insurance premiums, expanding coverage access through direct subsidy of premiums.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentProvides state-funded health insurance for adjunct faculty, expanding employment benefits and protecting workers' rights through mandatory coverage for eligible staff.95% confidence

Sub-Topics Insurance

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passed · Massachusetts · House Jul 27, 2026

H 5013: An Act to establish a celiac disease screening pilot program

By Representative Badger of Plymouth, a petition (subject to Joint Rule 12) of Michelle L. Badger and Joan B. Lovely for legislation to establish a celiac disease screening pilot program for certain children. Public Health.

Topics ✓ HealthcareSupports HealthcareEstablishes celiac screening pilot under public health, improving early detection access - directly advances healthcare services95% confidence

Sub-Topics Public Health

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in committee · Massachusetts · House Jul 29, 2026

H 4939: An Act to facilitate timely access to quality health care by expanding access to patient navigation

H 4939 requires health insurers and Medicaid plans to cover patient navigation services provided by certified community health workers. These services help patients access care by addressing chronic disease prevention, social needs screenings, health education, and overcoming barriers like language or health literacy. The bill mandates reimbursement for workers with national certification or approved training, effective January 1, 2026. It directly affects Medicaid-eligible patients and community health workers by expanding access to coordinated care support. The law also directs the Executive Office of Health and Human Services to secure federal funding for implementation.

Topics ✓ HealthcareSupports HealthcareMandates insurers/Medicaid to cover patient navigation services, expanding access for Medicaid-eligible patients by addressing barriers like language and health literacy, improving healthcare access.95% confidence

Sub-Topics Medicaid Public Health

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in committee · Massachusetts · House Jul 27, 2026

H 4961: An Act to increase access to healthcare for ostomy patients

This bill requires health insurers to cover all medical supplies for ostomy care (including management of surgically created or spontaneous fistulas) without forcing patients to use non-medical alternatives. It mandates that insurers transfer ostomy care records within 72 hours when patients switch coverage, ensures suppliers are reimbursed at Medicare rates, and extends prescriptions for these supplies to at least one year with no disruption in coverage. The law also requires suppliers to provide one month's advance notice before changing products, including samples for trial, and guarantees patients can return to their original product if substitutions compromise care. These provisions directly affect ostomy patients, healthcare providers, and insurers across Massachusetts.

Topics ✓ HealthcareSupports HealthcareBill mandates insurer coverage of ostomy supplies without alternatives, ensures record transfers during coverage changes, and guarantees continuous access - directly expanding healthcare access and protecting patient rights for a specific medica...95% confidence

Sub-Topics Medicare

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in committee · Massachusetts · House Jul 23, 2026

H 4959: An Act relative to health insurance coverage for hearing aids

This bill requires most health insurance plans in Massachusetts to cover hearing aids for insured residents. It mandates coverage for one hearing aid per hearing-impaired ear every 36 months, based on a physician's written statement of medical necessity, with coverage extending to the best-fit device (regardless of brand) and related services like fittings, adjustments, and repairs. The law caps patient copayments at $200 per hearing aid and prohibits higher deductibles or out-of-pocket costs than for other durable medical equipment. It applies to all group and individual health insurance policies, including non-group plans, ensuring consistent coverage for people with hearing loss.

Topics ✓ HealthcareSupports HealthcareMandates health insurance coverage for hearing aids with cost caps, expanding access and protecting patients from high out-of-pocket costs.95% confidence

Sub-Topics Insurance

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in committee · Massachusetts · House Jul 30, 2026

H 4896: An Act for supportive care for serious mental illness

H 4896 requires qualifying student health insurance plans to cover two specific mental health treatment programs: "Coordinated Specialty Care" for first-time psychosis (within 74 weeks) and "Assertive Community Treatment" for serious mental illness or emotional disturbance. It directly affects young people under 19 with serious emotional disturbance and adults 19+ with serious mental illness by mandating insurance coverage for these services without visit limits. Key provisions include requiring insurers to pay for these treatments through a bundled payment model (not per-service fees) and presuming medical necessity after a licensed professional's recommendation. The bill defines these terms to ensure consistent coverage under state insurance regulations.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for two mental health programs without visit limits, expanding access for youth and adults with serious mental illness.95% confidence

Sub-Topics Insurance Mental Health

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in committee · Massachusetts · House Jul 9, 2026

H 4934: An Act to improve access and care coordination for people with pain

This bill (H 4934) requires Massachusetts Medicaid insurers to cover non-opioid pain medications equally with opioids - prohibiting restrictions like labeling them "non-preferred" or imposing stricter prior authorization. It mandates comprehensive care coordination for Medicaid members with chronic pain, including access to integrated services (primary care, specialists, physical therapy, mental health) and individualized treatment plans by 2027. The bill also directs the state to collect data on chronic pain incidence, demographics, treatment costs, and care gaps, publishing reports every two years starting in 2028. These provisions directly affect Massachusetts Medicaid enrollees with chronic pain and their healthcare providers.

Topics ✓ HealthcareSupports HealthcareRequires equal Medicaid coverage for non-opioid pain meds and mandates integrated care coordination for chronic pain, improving access and treatment options.95% confidence

Sub-Topics Medicaid Mental Health Substance Abuse

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in committee · Massachusetts · House Jul 9, 2026

H 4940: An Act to redirect excessive health insurer reserves to support health care safety net programs

This bill requires health insurers with reserves exceeding 550% of risk-based capital to pay an assessment generating $400 million total. The funds are split equally: $200 million goes to the Health Safety Net Trust Fund (supporting community health programs) and $200 million to the Medicaid Stabilization Trust Fund (preventing access cuts for MassHealth beneficiaries). The assessment applies to insurers meeting specific reserve thresholds set by the Division of Insurance, with enforcement mechanisms including interest charges for late payments. The program expires on December 31, 2026.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill imposes assessment on insurers to generate $400M funding for health safety net and Medicaid programs, directly increasing public service funding through targeted revenue.95% confidence ✓ HealthcareSupports HealthcareRedirects insurer reserves to Health Safety Net and Medicaid Stabilization Trust Funds, increasing funding for community health programs and preventing access cuts for MassHealth beneficiaries.95% confidence

Sub-Topics Insurance Medicaid

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in committee · Massachusetts · House Jul 9, 2026

H 4948: An Act to further enhance rate review examinations conducted by the health care access bureau within the division of insurance

H 4948 creates a dedicated Health Care Access Bureau within Massachusetts' Division of Insurance to strengthen oversight of health insurance rates. The bureau, led by a deputy commissioner, will review premium rates for all health insurance plans sold in Massachusetts, focusing on consumer affordability (including deductibles and out-of-pocket costs), fairness for providers, and alignment with state healthcare cost growth goals. It requires insurers to pay an annual assessment totaling $2 million to fund the bureau's operations, including hiring specialized staff like a chief health economist and chief actuary. The bill directly affects all health insurers licensed in Massachusetts by requiring them to submit rate data for review and pay new funding assessments.

Topics ✓ HealthcareSupports HealthcareCreates dedicated bureau to review insurance rates for consumer affordability (deductibles/out-of-pocket costs), strengthening oversight to improve healthcare access and cost transparency.90% confidence

Sub-Topics Insurance

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