1 of 1
HOUSE DOCKET, NO. 2665 FILED ON: 1/16/2025
HOUSE . . . . . . . . . . . . . . . No. 1181
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Danielle W. Gregoire
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to redirect excessive health insurer reserves to support health care safety net programs.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Danielle W. Gregoire4th Middlesex1/16/2025 1 of 3
HOUSE DOCKET, NO. 2665 FILED ON: 1/16/2025
HOUSE . . . . . . . . . . . . . . . No. 1181
By Representative Gregoire of Marlborough, a petition (accompanied by bill, House, No. 1181)
of Danielle W. Gregoire that the Division of Insurance be authorized to impose an assessment to
support expenses associated with the delivery of health care services. Financial Services.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 1031 OF 2023-2024.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act to redirect excessive health insurer reserves to support health care safety net programs.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 Section 1. Chapter 118E of the General Laws is hereby amended by inserting the
2following new section:-
3 Section 83. (a) A carrier, as defined in Section 1 of Chapter 176O of the General Laws,
4shall pay an assessment to support expenses associated with health care costs covered by Chapter
5118E of the general laws. Such assessment shall be based on the net worth surplus available to
6health insurance carriers exceeding 550% of risk-based capital in calendar year 2023 in
7accordance with criteria developed by the Division of Insurance, in consultation with the
8executive office of health and human services. The executive office shall specify by regulation
9the method of calculating the assessment, procedures for payment of the assessment, and
10requirements for submission of data by health insurers. 2 of 3
11 (b) The executive office shall establish by regulation the mechanism for enforcing the
12assessment liability under this section in the event that a carrier does not make a scheduled
13payment, but the division may, for the purpose of administrative simplicity, establish threshold
14liability amounts below which enforcement may be modified or waived. This enforcement
15mechanism may include assessment of interest on the unpaid liability at a rate not to exceed an
16annual percentage rate of 18 per cent and late fees or penalties at a rate not to exceed 5 per cent
17per month.
18 (c) The amount of the assessment established by executive office in subsection (a) shall
19be sufficient, in the aggregate, to generate $400,000,000.
20 (d) The executive office, in consultation with the comptroller and the secretary of
21administration and finance, shall transfer $200,000,000 to the Health Safety Net Trust Fund
22established in section 66 of Chapter 118E and $200,000,000 to the Medicaid Stabilization Trust
23Fund established in section 2JJJJJJ of Chapter 29.
24 (e) Subsection (c) shall sunset on December 31, 2026.
25 Section 2. Chapter 29 of the General Laws is hereby amended by inserting the following
26new section:-
27 Section 2JJJJJJJ. (a) There shall be a Medicaid Stabilization Trust Fund which shall be a
28separate, nonbudgeted revenue fund to be administered by the secretary of health and human
29services. There shall be credited to the fund: (i) any transfers by the executive office in
30accordance with section 83 of chapter 118E (ii) an amount equal to any federal financial
31participation revenues claimed and received by the commonwealth for eligible expenditures
32made from the fund; (iii) any revenue from appropriations or other money authorized by the 3 of 3
33general court and specifically designated to be credited to the fund; and (iv) interest earned on
34any money in the fund. Amounts credited to the fund shall be expended, without further
35appropriation, to prevent reductions in access to care for MassHealth beneficiaries and
36reductions in reimbursement of healthcare services reimbursed by the program.
37 (b) Money in the fund shall be expended for Medicaid payments under an approved state
38plan or federal waiver; provided, however, that all Medicaid payments from the fund shall be: (i)
39subject to the availability of federal financial participation; (ii) made only under federally-
40approved payment methods; and (iii) consistent with federal funding requirements and all
41applicable federal payment limits as determined by the secretary. To accommodate timing
42discrepancies between the receipt of revenue and related expenditures, the comptroller may
43certify for payment amounts not to exceed the most recent revenue estimates as certified by the
44secretary to be transferred, credited or deposited under this section. The secretary shall, to the
45maximum extent possible, administer the fund to obtain federal financial participation for the
46expenditures of non-federal money from the fund. Money remaining in the fund at the end of a
47fiscal year shall not revert to the General Fund and shall be available for expenditure in
48subsequent fiscal years.
49 Section 3. Section 66 of chapter 118E is hereby amended by adding the following words
50subsection (b) after “money transferred from”:- “by the executive office in accordance with
51section 83 of this chapter,”