Governor Healey Further Limits Growth of Health Care Deductibles and Co-Pays

 Governor Healey Further Limits Growth of Health Care Deductibles and Co-Pays 

Under new action, Massachusetts will have tightest limits on out-of-pocket costs in the country, saving patients $232 per year 

BOSTON — Governor Maura Healey is announcing that her administration has taken further action to limit growth in health care deductibles, co-pays and other out-of-pocket costs for patients in 2027. Under guidance issued by the Division of Insurance, health insurance companies will be required to limit increases in patient cost-sharing to 3.6 percent for plans sold in the merged market beginning in January 2027, down from 4.8 percent. 

With this new action, Massachusetts will have the tightest limits on these out-of-pocket costs in the country, saving patients an estimated average of $232 per year. This comes after Governor Healey capped deductibles, co-pays and other out-of-pocket costs for the first time in state history last year. 

“We know that families across Massachusetts are struggling to afford health care, and unpredictable out-of-pocket costs are a major driver of that,” said Governor Maura Healey. “Last year, I was proud to become the first governor in Massachusetts history to cap co-pays and deductibles, and now we’re lowering that cap even further. These will be the tightest limits in the country to make sure the people of Massachusetts can afford to get the care they need.” 

“The quality of health care in Massachusetts is unmatched, but often becomes a financial burden for our residents,” said Lieutenant Governor Kim Driscoll. “With this latest cap on deductibles and co-pays, we're limiting the amount of money that comes directly out of the pockets of patients and families.” 

“Health care cost pressures are front and center, and this action protects families at a time when they need our assistance more than ever,” said Commissioner of Insurance Michael Caljouw. 

The Division of Insurance’s merged market guidance requires insurers to demonstrate that average member cost sharing across these products will not increase by more than 3.6 percent, as reflected in the five-year average change in inflation measured by the Consumer Price Index for the Boston region. This action is the result of legislation signed by Governor Healey in 2025 that increased the Insurance Commissioner’s consideration of affordability during his monitoring of the merged market. 

This action builds on the Healey-Driscoll Administration’s efforts to lower health care costs, including two bills signed by Governor Healey in 2025 to 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. Governor Healey has also eliminated prior authorization for many routine and essential services and created a Health Care Affordability Working Group charged with advancing additional proposals to reduce costs for people and businesses across the state.