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H 1236

An Act directing the division of insurance to regularly report on the performance of the merged non-group and small-group health insurance markets

194th Legislature (2025-2026) Introduced by John Lawn

Massachusetts must establish regular public reporting on its merged non-group and small-group health insurance market performance to enable ongoing oversight and accountability.

Hearing scheduled for 10/27/2025 from 10:30 AM-04:00 PM in Gardner Auditorium
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Bill Summary · H 1236

Legislative bill overview

H 1236 mandates that Massachusetts's Division of Insurance conduct and publish regular performance reports on the state's merged non-group and small-group health insurance markets. The bill requires ongoing monitoring and public disclosure of how these combined market segments are functioning, including metrics on competition, affordability, and market stability.

Why is this important

Massachusetts merged its non-group (individual) and small-group health insurance markets in 2014, a significant structural change affecting hundreds of thousands of residents and small business owners. Regular public reporting enables policymakers, insurers, and consumers to assess whether the merger is achieving its intended goals and identify problems requiring intervention, while also creating accountability for market performance.

Potential points of contention

  • Regulatory burden vs. transparency trade-off: Opponents may argue that mandatory regular reporting increases administrative costs for the Division of Insurance without clear evidence that additional reporting improves outcomes
  • Definition of "performance" metrics: Disagreement could emerge over which specific metrics should be tracked (premium rates, enrollment trends, insurer profitability, coverage adequacy) and how success should be measured
  • Market consolidation concerns: The reporting requirement implicitly acknowledges concerns about the merged market's performance, which could become politically contentious if data reveals adverse effects for consumers or small businesses seeking coverage

Compiled from official sources — confirm details with the bill’s official record.

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