Summary — S.476 (194th Gen. Ct., 2025–2026): Special Commission on a Statewide Long‑Term Services and Supports Benefit Program
Status: Introduced Feb 6, 2025; referred to committee(s) (see Procedural Status).
Presenter: Sen. Patricia D. Jehlen.
Primary purpose: To create a special commission to study and recommend how Massachusetts could establish a statewide long‑term services and supports (LTSS) benefit program, including design, financing, enrollment options, interaction with MassHealth/private coverage, and workforce implications.
What the bill would do (main purpose)
Create a 16‑member special commission charged with studying whether — and how — a publicly administered statewide LTSS benefit could be designed and implemented in Massachusetts. The commission is directed to develop findings and draft legislation for consideration by the Legislature.
Key provisions / tasks of the commission
- Examine inclusion of an LTSS benefit within the state disability insurance structure, including potential financing mechanisms such as a (nominal) payroll tax increase.
- Study enrollment models: voluntary contributions (direct or payroll deduction), mandatory enrollment with a voluntary opt‑out, eligibility standards, and benefit triggers (functional or cognitive limitations).
- Consider benefit design to allow people to plan for future LTSS needs and to purchase non‑medical supports (home health aides, adult day care, etc.) that help individuals remain in the community.
- Analyze interactions with MassHealth and other public programs, and coordination with private insurance.
- Assess long‑term care workforce demand and strategies to prepare the workforce.
- Evaluate public, private, and hybrid financing models and the viability of a joint public‑private system.
Commission composition (16 members)
- Chair: Secretary of Health & Human Services (or designee).
- Secretary of Aging and Independence (or designee).
- Commissioner of Public Health (or designee).
- Assistant Secretary for MassHealth (or designee).
- Chairs of the Joint Committee on Elder Affairs (or designees).
- Ten governor appointees representing: Home Care Aide Council; Home Care Alliance of MA; Mass Aging Access; Massachusetts Senior Care Association; LeadingAge Massachusetts; AARP Massachusetts; Local 1199 SEIU; NAIFA Massachusetts; a long‑term care insurance provider; and an expert on long‑term care/aging policy.
Required use of prior actuarial work
The commission must review and use findings from an independent actuarial study conducted by Milliman, Inc. (authorized in item 4000‑0300, Ch. 18, Acts of 2024) to inform recommendations on design, financing, and feasibility.
Deliverable / timeline
The commission must file a report with findings, recommendations, and draft implementing legislation with the Senate and House clerks and the Joint Committees on Elder Affairs and Health Care Financing no later than one year after the act’s effective date.
Who would be affected
- Working adults (potential payroll contributions or opt‑out arrangements).
- Individuals with chronic, disabling, functional or cognitive limitations who require LTSS.
- Long‑term care workers and provider organizations (workforce planning, potential increased demand).
- Employers, MassHealth, private insurers, and long‑term care insurers.
Procedural status and notes
- Introduced in the MA Senate Feb 6, 2025; docket/filed Jan 17, 2025 (S.D. 1962).
- Referred to various committees at different times (Elder Affairs; Aging & Independence; Finance). A public hearing was scheduled for 06/24/2025 (B‑1).
- An accompanying new draft is noted as S.2645 (10/16/2025).
- Note: Some metadata supplied with the request (title referencing an “OUT act,” and a list of federal‑level sponsors) appears inconsistent with the bill text; the substantive text of S.476 establishes the LTSS benefit study commission described above.
This bill does not itself create benefits or taxes but is designed to produce a legislative blueprint (including draft bills) for a statewide LTSS benefit program.
