Healey-Driscoll Administration Limits Deductibles and Co-Pays to Control Health Costs for Patients

  Healey-Driscoll Administration Limits Deductibles and Co-Pays to Control Health Costs for Patients 

This is the first time the state has taken action to require insurers to limit this health cost driver 

BOSTON – Governor Maura Healey and her administration are taking action to limit the cost of health care deductibles and co-pays that patients are required to pay. 

Commissioner of Insurance Michael Caljouw issued regulatory guidance that requires insurance companies to limit the growth of deductibles and co-pays for patients at the rate of medical inflation (approximately 4.8 percent). Over the past two years, deductibles charged to patients have gone up by nearly 23 percent in the merged market – resulting in increased costs of over $200 per patient.  

This is the first time the state has taken action to limit deductibles in this way, as it is the result of legislation signed by Governor Healey in 2025 that increased the Commissioner’s consideration of affordability during a review of the merged market. The limit on deductibles and co-pays will go into effect in January 2026. 

“Massachusetts families across the state are struggling with high health care costs,” said Governor Healey. “Deductibles and co-pays are a significant health cost driver, so we are taking action to limit those costs that come right out of the pockets of patients and families.”  

“Massachusetts is home to the greatest health care system in the world, but we need to make it more affordable for people,” said Lieutenant Governor Kim Driscoll. “This directive is one tool in our toolkit to lower costs for people and prevent large spikes in deductibles and co-pays.” 

“Deductibles and co-pays have been growing too fast – now outpacing wages and salary growth for our residents,” said Insurance Commissioner Michael Caljouw. “Today’s announcement is an important first step to protecting our residents from these difficult costs.” 

Health care costs are one of the biggest strains on Massachusetts household budgets. CHIA’s most recent Annual Report on the Performance of the Massachusetts Health Care System found that cost-sharing is one of the main drivers of high health care costs and has been growing faster than statewide wages and salaries.  

"Massachusetts ranks first in the country for health care coverage, however many residents can't afford the medical care they need,” said Health Care For All Executive Director Amy Rosenthal. “Health Care For All hears from thousands of callers on our free HelpLine who are struggling to pay their deductibles and co-pays, and those who skip necessary appointments altogether to save money. This directive is a meaningful step in addressing our state’s health care affordability challenges.” 

This action builds on the Healey-Driscoll Administration’s efforts to lower heath care costs. Earlier this year, Governor Healey signed two bills that lower health care costs, cap prescription drug costs at $25, and improve access to primary care and increase oversight of the health care industry to protect patients and providers. She also expanded affordable health care coverage to 260,000 more people in Massachusetts through ConnectorCare. She also signed a bill to increase access to breast cancer screening and early detection treatments for little to no cost and made prenatal vitamins and over the counter (OTC) oral contraceptives free for MassHealth members and Health Safety Net (HSN) patients.