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HD 1201

An Act relative to unpaid health insurance deductibles

194th Legislature (2025-2026) Introduced by Steven Howitt

Insurers would be liable for and must reimburse providers for all patients’ unpaid deductibles and co-pays.

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WeVote Research Nonpartisan
Bill Summary · HD 1201

Summary: House Bill 1201 – An Act relative to unpaid health insurance deductibles

Overview

House Bill 1201, titled “An Act relative to unpaid health insurance deductibles,” is a proposed Massachusetts act introduced on January 14, 2025 (House Docket No. 1201; accompanying bill House No. 1196). The bill is described as a proposed measure pending status updates. It mirrors prior related efforts (similar matter filed in 2023-2024 as House Bill 1045). The bill would create a broad requirement that insurances companies bear responsibility for patients’ unpaid deductibles and co-payments and would obligate insurers to reimburse healthcare providers accordingly. The Massachusetts Division of Insurance would implement the necessary regulations.

Key Provisions

  • Primary requirement: Regardless of any contrary law, any insurer or company licensed or authorized to transact accident and health insurance in Massachusetts shall be liable for all members’ unpaid deductibles and co-payments.
  • Reimbursement obligation: Insurers must reimburse health care providers for those unpaid deductibles and co-payments.
  • Regulatory authority: The Division of Insurance is mandated to promulgate all rules and regulations necessary to implement and enforce the section.

Affected Parties

  • Insurers and health insurance companies licensed or authorized to transact accident and health insurance in Massachusetts.
  • Health care providers that bill patients for deductibles and co-pays (as they would be reimbursed by insurers under the bill).
  • Health care system consumers/members who incur deductibles and co-pays (potential reduction in patient unreimbursed balances).

Implementation and Timeline

  • No explicit effective date is stated in the bill text available here.
  • The Division of Insurance would be responsible for developing, issuing, and enforcing implementing regulations.
  • Given the regulatory hook, timelines for compliance would be set via regulatory rulemaking after enactment.

Context and Implications

  • Policy intent: To shift financial risk for unpaid patient cost-sharing (deductibles and co-pays) from patients/providers to insurers, ensuring providers are reimbursed for unpaid amounts.
  • Potential impacts:
    • Insurer cost and premium considerations, depending on the scope of liability and how “unpaid” is determined.
    • Provider revenue assurance for services rendered to insured patients.
    • Administrative processes for determining and validating unpaid deductibles/co-pays and for insurer reimbursements.
  • Public discussion points (not in the text): effectiveness in reducing patient financial barriers vs. potential increases in premiums or changes to cost-sharing structures; how bad debt and charity care are handled under this framework.

Background

  • The bill is a reintroduced concept, previously seen as House Bill 1045 in the 2023-2024 session, indicating ongoing interest in addressing unpaid patient cost-sharing through insurer responsibility.

If you’d like, I can add a side-by-side comparison with the prior version (HB 1045) and outline potential regulatory considerations the Division of Insurance might address in implementing rules.

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

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