Mass. Family Health Premiums Climbed 38% Since 2019, Outpacing the U.S.

Massachusetts family health premiums rose 38% from 2019 to 2025, outpacing a 28% increase nationwide, according to a Massachusetts Health Policy Commission report discussed at the agency’s annual cost trends hearing on Tuesday, Nov. 10. The average premium for employer-based family coverage reached nearly $30,000 last year, including employer and employee contributions, the Boston Globe reported from the study.

David Seltz, the commission’s executive director, told the hearing that the status quo is not sustainable. “We need to confront the underlying structural challenges driving health care spending,” he said, according to the Globe. State House News Service, which also covered the hearing at Suffolk University Law School, quoted him calling the more than $34,000 in average total family health costs “staggering.”

By the numbers: premiums, out-of-pocket costs and the U.S. comparison

The 38% rise in Massachusetts beat household income growth and inflation, the commission found, the Globe reported. Nationally, premiums rose 28% over the same years, led by gains in Nebraska, Oregon and New Hampshire, according to the commission. Alaska, New York and New Jersey had the highest average costs, the Globe said. By The Boston Report’s calculation from the commission figures reported by the Globe, the Massachusetts increase was 10 percentage points faster than the national figure.

Seltz also placed the new figures in a longer arc, telling the hearing that family premiums in the state have grown from $7,000 a year in 2000 to nearly $30,000 in 2025, State House News Service reported. At recent growth rates, premiums will hit $50,000 a year by 2032, according to the commission, the Globe and State House News Service both reported. For 10% of Massachusetts families, premiums already exceeded $41,000 last year, the Globe said the researchers found.

With out-of-pocket spending included, the average cost of health care for a Massachusetts family exceeded $34,000 in 2025, or $2,846 a month, the Globe reported. The Globe, citing research by the state Center for Health Information and Analysis, also said more than one-fourth of Massachusetts residents reported that they or a family member had an unmet health care need because of costs.

Those costs now exceed housing costs in “most regions” of the state, though not in Boston, Seltz said, according to State House News Service. The Globe wrote that health care costs greatly exceed housing costs in some regions, particularly in Western Massachusetts. Cape Cod and the islands had the highest premiums in the state based on 2024 data, according to an analysis Seltz shared, State House News Service reported.

Why costs keep rising

The commission pointed to heavy use of expensive anti-obesity drugs, more costly imaging tests and other factors behind the surge, the Globe reported. Alan Sager, a professor of health law, policy and management at Boston University, told the Globe he was not surprised. Massachusetts, he said, is dominated by expensive teaching hospitals and has a high concentration of medical specialists but a shortage of primary care doctors. “Our health care costs have long been the highest or nearly the highest in the country, and, therefore, in the world,” Sager said. “To cover high costs, you have to generate high revenue.”

Lora Pellegrini, chief executive of the Massachusetts Association of Health Plans, said in a statement that the focus on premiums was misplaced because “Massachusetts health insurance premiums are a direct reflection of health care costs.” She said more than 40 state reports have pointed to causes that include rising spending on prescription drugs such as GLP-1 medicines for weight loss and diabetes, costlier inpatient and outpatient care, and billing at the highest codes. As a result, she said, Massachusetts has exceeded the state’s 3.6% annual growth benchmark in eight of the past 12 years, including each of the past four. “Health plans cannot solve the health care affordability challenge alone,” Pellegrini said, according to the Globe.

Niyum Gandhi, Mass General Brigham’s chief financial officer, told the commission that rising costs partly reflect expensive cell and gene therapies and that inflation has raised “labor costs in one of the most expensive housing markets in the country,” the Globe reported. Patrick Gilligan, chief executive of Point32Health, the parent of Harvard Pilgrim Health Care and Tufts Health Plan, told the hearing that the state should consider a board to examine drug prices, saying his company does not “have much say around the price of medications,” according to State House News Service.

What officials say should change

Seltz noted that a health care affordability panel appointed by Gov. Maura Healey released 12 recommendations in August, the Globe reported. Those proposals include limits on extra fees for out-of-network care, discouraging some costly diagnostic tests such as MRIs for lower back pain, and encouraging hospital systems to provide less intensive care in patients’ homes.

The Globe noted that Mass General Brigham recently confirmed it would cut in half the number of patients treated at one time in its Home Hospital program, which had been losing an average of $30 million a year. After the cuts, the program will treat no more than 30 patients at once, down from a capacity of 70 in August 2024, the Globe reported. The same article, published Tuesday, also noted that unionized nurses at Brigham and Women’s Hospital were then preparing for a strike over wages; the nurses and the hospital later reached a tentative agreement late Wednesday, averting a walkout that had been set for Thursday morning.

The state Senate and House have passed rival bills to raise the share of spending that goes to primary care from 6.6% to 15% without increasing overall expenses, Seltz noted, according to the Globe. The Senate version would require the change by 2030; the House bill would push the deadline to 2036. Lawmakers hope to reconcile the bills by the end of the year, the Globe reported, but insurers have raised concerns that both versions would increase overall expenses and lead to higher premiums. Attorney General Andrea Campbell told the hearing that her office is “over-communicating” with the Legislature to “hopefully get something done,” State House News Service reported, and she released a new report on disparities in primary care payments, including supplemental payments from commercial insurers.

The hearing came as hospitals prepare for federal Medicaid cuts next year under a law President Donald Trump signed, the Globe reported, and as Democrats prepare to take control of Congress in January. People who buy coverage through the Massachusetts Health Connector already face a separate set of deadlines and subsidy questions for 2027 open enrollment. The commission’s new figures show why those costs matter for family budgets across Massachusetts, where health spending now competes with housing in much of the state. Broader cost-of-living pressure, including energy and child care, is laid out in The Boston Report’s guide to Massachusetts affordability.

Sources

• Boston Globe: Health insurance premiums in Mass. climb 38% since 2019, outpacing the national average, report finds
• State House News Service: Family health costs now exceed housing in most of Mass., HPC told
• Newsradio 95 WXTK: Health Care Impacts Family Finances
• Massachusetts Health Policy Commission: Annual Cost Trends Report