The Massachusetts Division of Insurance has approved significant health insurance premium increases for 2027 in the merged individual and small-group market, affecting nearly 700,000 Massachusetts residents and small businesses.
Following negotiations with insurers, regulators reduced the average requested premium increase from 12.9% to 10.4%, a change Governor Maura Healey said will save consumers and employers an estimated $72 million compared with the insurers' original filings. Despite these reductions, the approved increases remain nearly three times higher than the Commonwealth's 3.6% health care cost growth benchmark.
The Division also rejected Fallon Community Health Plan's proposed 25.7% premium increase, finding it excessive. Fallon may pursue an administrative appeal.
Among the state's largest insurers, approved premium increases include:
- Blue Cross Blue Shield of Massachusetts: 13.2% (reduced from a requested 15.3%)
- Tufts Health Plan: 7.5% (reduced from 11.8%)
- Harvard Pilgrim Health Care: 6.7% (approved as filed)
Insurers attributed the continued upward pressure on premiums to rapidly rising pharmaceutical costs – particularly high-cost specialty medications – and increasing provider reimbursement expenses. Industry representatives emphasized that long-term affordability will require addressing the underlying drivers of healthcare spending rather than relying solely on premium rate negotiations.
Employer organizations warned that the increases will further strain small businesses already facing rising labor and operating costs. The approved rates also renew attention on the Commonwealth's ongoing efforts to improve healthcare affordability, as stakeholders await recommendations from Governor Healey's Health Care Affordability Work Group.