Commissioner rejects proposed rate increase from Fallon Community Health Plan, re-negotiated seven proposals to save $72 million for 670,000 residents

Governor Maura Healey has announced that the Division of Insurance has negotiated down proposed rate increases from seven health insurers, saving Massachusetts residents and businesses a projected $72 million in health care premiums for 2027.

The Division of Insurance re-negotiated lower rates with Blue Cross Blue Shield of Massachusetts HMO Blue, INC., Harvard Pilgrim Health Care, Health New England, Mass General Brigham Health Plan, Tufts Health Public Plans, United Healthcare and WellSense Health Plan. These efforts will result in savings for the approximately 670,000 Massachusetts residents and businesses who are enrolled in these plans in the Massachusetts merged market.

Commissioner Michael Caljouw also rejected Fallon Community Health Plan's proposed 25.7% rate increase for being excessive and inconsistent with his responsibility to Massachusetts consumers and businesses. This disapproval is now subject to an administrative appeal process should the insurance company choose one.

"Massachusetts residents and businesses are already struggling with the high cost of health care. Nobody can afford massive increases in their health insurance premiums on top of that," said Governor Healey. "Commissioner Caljouw and his team are always looking for ways to lower people's costs – whether that's by capping co-pays and deductibles or removing prior authorizations. Now, he's saving people tens of millions of dollars next year by negotiating with affordability as his focus."

Last year, Governor Healey signed legislation that increased the Division of Insurance's consideration of affordability during his review of the merged market rate filings. As a result, Commissioner Caljouw was able to initially save residents and businesses $54 million in 2026 by re-negotiating rate increases.

Governor Healey has also taken action to cap health care co-pays and deductibles for the first time in Massachusetts history, and further lowered that cap this year to save people an estimated average of $232 per year. She also eliminated prior authorization requirements for many routine and essential health care services, reducing delays and administrative costs for patients and providers, and prohibited medical debt from appearing on consumer credit reports.