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HD 1026

An Act ensuring equal access to medical treatments essential for people with a developmental disability, intellectual disability, or autism

194th Legislature (2025-2026) Introduced by Jim Arciero and 24 co-sponsors

Massachusetts bill mandates insurance coverage for medically necessary treatments for developmental, intellectual disabilities, and autism to eliminate cost barriers to care.

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Bill Summary · HD 1026

Legislative bill overview

HD 1026 requires health insurance plans in Massachusetts to provide equitable coverage for medical treatments needed by individuals with developmental disabilities, intellectual disabilities, or autism spectrum disorder. The bill aims to eliminate insurance barriers that may prevent these populations from accessing necessary therapies and interventions that are medically appropriate.

Why this is important

People with these disabilities often require specialized treatments (behavioral therapy, speech therapy, occupational therapy, etc.) that insurance companies may deny or limit coverage for. Without this protection, families face substantial out-of-pocket costs that can make essential care inaccessible, deepening health disparities for vulnerable populations.

Potential points of contention

  • Cost implications: Insurance companies and employers may argue the mandate increases premiums by requiring coverage of treatments they consider experimental, duplicative, or unnecessary
  • Definition specificity: Ambiguity about which treatments qualify as "essential" could lead to disputes between insurers and patients over coverage decisions
  • Implementation burden: Determining medical necessity for individualized disability needs requires robust review processes that may increase administrative complexity and delays in treatment access

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

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