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Bill

SD 214

An Act relative to association health plans

194th Legislature (2025-2026) Introduced by Bruce Tarr

Authorizes employer and self-employed associations to pool health insurance purchases under state regulation, potentially lowering costs but risking market fragmentation and adverse selection against remaining insureds.

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Bill Summary · SD 214

Legislative bill overview

Bill SD 214 would authorize the creation and regulation of association health plans (AHPs) in Massachusetts, allowing groups of employers, self-employed individuals, or other associations to pool together to purchase health insurance coverage. The bill establishes state-level oversight and requirements for these plans, including consumer protections and financial solvency standards.

Why is this important

Association health plans could potentially lower insurance costs for small businesses and self-employed workers by increasing their bargaining power in the insurance market. However, the bill's impact depends heavily on how AHPs are structured and regulated—they could either improve access and affordability or create new risks if consumer protections are inadequate or if they attract healthier enrollees while leaving traditional markets with sicker, costlier populations.

Potential points of contention

  • Risk of adverse selection: If AHPs can selectively attract younger, healthier members, traditional insurance markets could be left with older, sicker enrollees, driving up premiums for those unable to join AHPs
  • Consumer protection gaps: Determining adequate state oversight standards to prevent insolvency, fraud, or inadequate claims-handling without stifling plan formation
  • Market fragmentation: Whether allowing AHPs undermines the existing individual and small-group insurance market structure that Massachusetts has carefully regulated since health reform

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

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