New Probe on Group Health Insurance

Governor Charlie Baker of Massachusetts ordered a new probe into the health insurance market. Under executive order 589, the new Merged Market Advisory Council will gather and verify information about insurance rates, producing a helpful report for lawmakers to adjust insurance legislation.

The report is due on April 30, 2020.

council meeting for group health probe
The first step in any decision is to research, and that’s just what’s happening now.

The Council

The newly formed council consists of 13 members, 10 of them experts in the health insurance industry.  This report’s entire purpose is to give an overview of the merged market based on analysis to “ensure the long-term stability of coverage for individuals and small employers in the merged market and the affordability of insured health benefit plan products offered therein.” (No. 589 Merged Market Advisory Council)

To help balance the report and keep it truthful, the council members will operate by considering:

  • The general stability of the merged market risk pool
  • Trends correlating with the risk pool and their impacts on premiums
  • What drives health care costs to increase
  • Policies that threaten market stability
  • Strategies to help keep market costs down

Why It Was Formed

Baker supported his own recommendation for a fact-finding committee by arguing for the complex nature that the market presents. No two people have the same view of it, and it gets even murkier as you talk to both providers and the people purchasing the premiums.

group health probe meeting between two industry professionals
With better information, we can see some better changes for health insurance in the future.

Essentially, Massachusetts’ hospitals, physician groups, and insurers will report their spending on primary care and behavioral health to the state agency. The projected spending increase in these areas is 30% over the next three years, an unreal amount considering the state’s cap on spending is 3.1% annually.

Hospitals are already in a losing situation here, with those two healthcare options losing money for them, especially behavioral health. They just don’t provide the same insurance reimbursement as the more sensational options like cancer.

The bill will also touch on drug prices. After review, state representatives can place regulations on predatory prescription drug practices like:

  • Gag rules, preventing patients from hearing about cheaper drug options
  • Drugmakers who charge more annually than the 2% inflation can keep up with
  • Any drug that costs someone $50,000 or more

The Results

If lawmakers are to better understand ways to improve insurance legislation (specifically to help with rapidly increasing healthcare costs), the first step is to compile accurate information for how the market is affected. 

The creation of this council instills hope in Massachusetts’ citizens. Informed decisions are how our government should operate. With such a convoluted case like insurance, an advisory council will provide verified facts to create a better healthcare system, with more satisfied individuals.

With all the constant insurance changes occurring, there might be some confusion as to what the rates will be, and if it is affordable. If it is too much, we can help. EZ.Insure will compare plans within your region and assess which fits your needs and budget. You will be connected with your own highly trained agent that will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing, or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.


About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

Leave a Reply

Your email address will not be published. Required fields are marked *