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HD 4027

An Act updating the mandated benefit review process

194th Legislature (2025-2026) Introduced by Dennis Gallagher and 1 co-sponsor

Massachusetts updates its health insurance mandated benefit review process to modernize how the state evaluates and implements required insurance coverage requirements.

Senate concurred
0
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Bill Summary · HD 4027

Legislative bill overview

HD 4027 updates Massachusetts's mandated benefit review process, which determines what health insurance coverage requirements the state imposes on insurers. The bill modernizes the procedures and criteria used to evaluate whether new health benefits should be mandated by state law. This addresses how the state systematically adds coverage requirements that can affect insurance premiums and plan design.

Why is this important

Mandated benefits directly impact insurance costs for employers and individuals, as required coverages increase premium prices. The review process determines which treatments, services, or providers must be covered—decisions affecting both healthcare access and affordability. Updating this process can improve how the state evaluates whether new mandates provide sufficient public health benefit relative to their cost impacts.

Potential points of contention

  • Cost vs. access tradeoff: Streamlining mandates could limit coverage for some treatments, or conversely, expanded mandates could raise premiums for consumers and small employers
  • Stakeholder influence: The revised process may shift power between insurers, healthcare providers, patient advocacy groups, and state officials in determining coverage requirements
  • Evidence standards: Changes to how the state evaluates scientific evidence for new benefits could either raise or lower the bar for mandate approval, affecting innovation in coverage

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

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