Massachusetts Cuts Red Tape for Diabetes, Maternity Care

Imagine needing insulin for your diabetes but having to wait days for an insurance company to approve it first. That roadblock just disappeared for Massachusetts patients.

Governor Maura Healey announced sweeping health insurance reforms Wednesday that eliminate prior authorization requirements for a wide range of medical services. Doctors can now provide care immediately without seeking insurer permission first.

The changes cover essential services including primary care visits, chronic disease management, reproductive and maternity care, physical therapy, and substance use treatment. For diabetes patients specifically, insulin pumps, monitoring devices, and medications no longer require any pre-approval.

"You won't need it for the first time or for subsequent appointments," Healey explained at the State House. "You won't need it for any adjustments or upgrades that you get. And you won't need it if you change jobs either."

The new regulations apply to every health insurer operating in Massachusetts. The state plans to file the rules this week, followed by a public comment period before they take effect.

The reforms address a growing crisis in the state. More than a quarter of Massachusetts residents reported that they or a family member skipped necessary medical care in 2025 because of cost concerns, according to the state's Center for Health Information and Analysis.

Massachusetts now carries the unfortunate distinction of having the highest family health insurance premiums in the country. Dr. Kiame Mahaniah, the state's health and human services chief, put it bluntly: "Our health care system has reached a breaking point where costs are fast outpacing our ability to pay for care."

The Ripple Effect: Healey isn't stopping with these reforms. She launched a new working group Wednesday focused specifically on health care affordability, with a June deadline for recommendations.

The group brings together state lawmakers, business leaders, and health care industry representatives. Lisa Murray from Citizens Bank and former state health secretary Kate Walsh will lead the panel as it explores more efficient payment systems and innovative uses of technology to improve patient care.

"I'm setting up this working group because I want action," Healey said. "I don't want a protracted process where we study an issue for months or years at a time."

For Massachusetts families who've been choosing between medications and groceries, help is finally arriving.