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H 4559

An Act establishing a special commission on a statewide long-term services and supports benefit program

194th Legislature (2025-2026) Introduced by Pat Jehlen and 2 co-sponsors

Establish a 27-member commission to study and design a statewide long-term services and supports benefit, including enrollment, financing, and integration with MassHealth.

Committee recommended ought to pass and referred to the committee on House Ways and Means
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Bill Summary · H 4559

Summary: Bill H.4559 – Act Establishing a Special Commission on a Statewide Long-Term Services and Supports Benefit Program

Overview

H.4559 proposes creating a special commission to study and recommend the design and implementation of a statewide long-term services and supports (LTSS) benefit program in Massachusetts. The commission would review how such a program could fit within the existing disability insurance framework, financing options, enrollment structures (including mandatory enrollment with opt-out), and coordination with public programs like MassHealth. The goal is to enable individuals with functional or cognitive limitations to plan for and access nonmedical LTSS while maintaining community-based supports.

Purpose and Intent

  • Study and report on whether and how a statewide LTSS benefit could be included as a benefit within the state disability insurance structure.
  • Explore enrollment options for working adults, including premium contributions (direct or via payroll deductions).
  • Consider mandatory enrollment with an opt-out provision.
  • Provide a basic insurance mechanism for adults who meet eligibility and have functional or cognitive limitations.
  • Support community-based access to nonmedical LTSS (e.g., personal care, homemaker services, meal delivery, case management).
  • Help offset LTSS costs for adults with chronic or disabling conditions, potentially for a defined period or until death.

Key Provisions and Provisions to Study

  • The act creates a special 27-member commission to study and make recommendations (Section 2).
  • The commission’s study scope (Section 1) includes:
    • Whether the LTSS benefit could be integrated into the disability insurance structure.
    • Enrollment and premium financing options (including payroll deductions).
    • Mandatory enrollment with opt-out, and the design of a basic insurance benefit.
    • Planning for future LTSS needs and keeping individuals in their communities through nonmedical supports.
    • Financial viability and cost-offset considerations for individuals with chronic/c disabling conditions.
  • Section 3 directs the commission to review the independent Milliman actuarial study (2024) on financial options for public, private, and public-private LTSS options (item 4000-0300, Chapter 18, Acts of 2024) and to use its findings to address:
    • Program design and implementation options (eligibility, enrollment, financing, administration, alignment with MassHealth and other resources like the home care program under Chapter 19A).
    • Coordination with existing private coverage and health care benefits.
    • Workforce implications and strategies to prepare the LTSS workforce for growing demand.
    • Viability of a joint public-private system to maximize accessibility.
  • Section 4 requires a final report with findings, recommendations, and proposed draft legislation no later than two years after the act’s effective date.

Commission Composition

The 27-member commission includes:
- Government leadership/designates:
- Secretary of Health and Human Services (chair)
- Secretary of Aging and Independence (or designee)
- Commissioner of Insurance (or designee)
- Assistant Secretary for MassHealth (or designee)
- Chairs of the Joint Committee on Aging and Independence (or designees)
- Chairs of the Joint Committee on Financial Services (or designees)
- 19 gubernatorial appointees representing a broad cross-section of stakeholders, including:
- Home Care Aide Council; Home Care Alliance of MA; Massachusetts Aging Access Association; Massachusetts Senior Care Association; LeadingAge Massachusetts; Massachusetts Assisted Living Association; AARP MA; Local 1199 SEIU; Massachusetts Academy of Elder Law Attorneys; Massachusetts Senior Action Council; Blue Cross Blue Shield of MA Foundation; National Association of Insurance and Financial Advisors of MA; Life Insurance Association of MA; Massachusetts Business Roundtable; a long-term care insurance provider; an actuary with LTC experience; an expert on long-term care and aging policy; an intergenerational advocate.

Affected Parties

  • Working adults eligible for enrollment and payroll deduction contributions.
  • Adults with functional or cognitive limitations needing LTSS.
  • Individuals relying on nonmedical LTSS (home care, personal care, homemaker services, etc.).
  • Public programs (MassHealth, Chapter 19A home care program) and providers of public LTSS.
  • Long-term care insurers, employers, and workforce entities in the LTSS sector.
  • Stakeholder organizations representing aging, advocacy, and care-provider interests.

Procedural and Timeline Aspects

  • Introduced: October 2, 2025.
  • Status: Committee recommended ought to pass; referred to the House Ways and Means Committee.
  • Previous actions include: discharge to House Rules (Oct 27, 2025) and reporting favorably from the Aging and Independence Committee (Oct 2, 2025).
  • Reporting deadline: No later than two years after the act’s effective date, with drafts of proposed legislation included.

Potential Impact

If enacted, H.4559 could lead to a statewide LTSS benefit framework funded through a mix of premiums and public/private financing, with mandatory enrollment options and strong alignment with MassHealth. It would shape policy, coverage design, and workforce planning for LTSS, potentially expanding access to community-based supports and changing how families plan for long-term care costs.

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

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