Health Announce: Oct. 6, 2025

10/07/25

Topics for this week’s Health Announce:

  1. 12,600 older adults and individuals with disabilities enrolled in BCBS Medicare Advantage PPO Plan facing disruption in their access to care as primary care doctors lose in-network status.
  2. Commissioner of the Massachusetts Department of Mental Health, Brooke Doyle, to resign effective today.
  3. The federal shutdown continues.
  4. Fall MTF Webinar registrations open.
  5. Health Connector Open Enrollment begins soon.
  6. RESOURCE – Health Care for All Immigrant Health Toolkit.
  7. MLRI comments on proposed managed care regulations.

Be well,

Health Law Unit
Massachusetts Law Reform Institute

1. 12,600 older adults and individuals with disabilities enrolled in BCBS Medicare Advantage PPO Plan facing disruption in their access to care as primary care doctors lose in-network status.

Blue Cross Blue Shield of Massachusetts (BCBS), the largest health insurer in the state, offers a Medicare Advantage PPO plan, and as of January 1, 2026, BCBS Medicare Advantage PPO’s contract with Beth Isreal Lahey Health Performance Network will expire. About 12,600 individuals with disabilities and older adult patients will have to change insurers or pay higher out-of-network costs to continue to see primary care doctors that are part of the Beth Isreal network. Alternatively, those patients will have to find new primary care doctors. This does not affect people enrolled in the BCBS Medicare Advantage HMO Plan.

This change comes on top of the notice sent to BCBS Medicare Advantage (both HMO and PPO) plan participants last week that as of January 1, 2026, Mass General Brigham (MGB) primary care providers will no longer be in network. This affects nearly 3,200 people. MGB primary care doctors will also newly be out of network for about 15,600 customers of UnitedHealthcare Medicare Advantage plans.

2. Commissioner of the Massachusetts Department of Mental Health, Brooke Doyle, to resign effective today.

On Friday, Massachusetts Department of Mental Health (DPH) Commissioner Brooke Doyle announced her resignation, effective today, Monday, October 6, 2025. Deputy Commissioner Beth Lucas will be the interim commissioner until a new one is named by the Governor. Commissioner Doyle oversaw DMH’s launch of Community Behavioral Health Centers and the addition of hundreds of adult and pediatric inpatient beds at acute care hospitals and new and existing psychiatric facilities. In this past year, Commissioner Doyle was subject to a vote of no confidence by members of SEIU Local 509, DMH case managers’ union, in the wake of significant proposed cuts by the Healey Administration.

3. The federal shutdown continues.

Last week, the federal government shut down when the GOP-led house continuing resolution (CR) failed to pass the Senate because it did not garner any Democratic support. Democrats have said they want to negotiate with the GOP to extend the enhanced premium tax credits for Affordable Care Act (ACA) marketplace coverage, as well as reverse the Medicaid cuts passed in the Reconciliation Act of 2025. According to the Massachusetts Health Connector, if the enhanced premium tax credits expire at the end of the year, over 337,000 Massachusetts residents will see their premiums increase along with increased healthcare costs.

Doctors in Massachusetts and across the country have cancelled telehealth visits for Medicare beneficiaries since Congress allowed the federal authority to lapse. Telehealth for behavioral health services under Medicaid is not affected, since Congress made that coverage permanent in 2021. While providers can still offer the service, they must make it clear to patients that Medicare currently will not pay for them (though some hope that Congress will provide a retroactive fix). Fifteen percent of people on traditional Medicare have used telehealth services at some point in the first quarter of 2025; nearly thirty percent of individuals eligible for Medicare due to disability used telehealth services at some point in the first quarter of 2025.

4. Fall MTF Webinar registrations open.

The Massachusetts Health Care Training Forum (MTF) meetings for the fall have been posted, and registration is open.

5. Health Connector Open Enrollment begins soon.

Open enrollment for the Massachusetts Health Connector, the state’s healthcare marketplace, begins on November 1, 2025, and lasts through January 23, 2026. For insurance coverage beginning January 1, 2026, individuals need to enroll by December 23, 2025. Information about open enrollment and help with picking a health plan is available through Health Care for All.

Alarmingly, there are many changes contained in the Reconciliation Act of 2025 (HR 1) that have affected coverage and costs both this year already as well as for next year. 

  • The Special Enrollment Period (SEP) for people with incomes at or below 150% of the federal poverty level (FPL) ended August 25, 2025. For people who miss the open enrollment window, their access to coverage may be limited.
  • ConnectorCare Plan Type 1 ends as of January 1, 2026 due to changes in HR 1.
  • The expiration of the enhanced premium tax credits means some members will qualify for less financial help, and members whose household income is above 400% FPL will no longer qualify for financial help.

6. RESOURCE – Health Care for All Immigrant Health Toolkit.

Health Care for All (HCFA) has released the Immigrant Health Toolkit, available here. A project of the Immigrant Health Access Coalition (IHAC) and the efforts of HCFA, Health Law Advocates (HLA), the Massachusetts Law Reform Institute (MLRI) and the Massachusetts Immigrant and Refugee Advocacy (MIRA) Coalition, the toolkit complies information and resources to help answer questions and address issues related to coverage and care for immigrants in Massachusetts.

Here's a list of the current resources available:

  • Guides to Immigrant Eligibility for Health Insurance
  • Attorney General Guidance
  • CMS-DHS Data Sharing Talking Points
  • Referral List for Immigration Legal Support
  • Educational Resources
  • Information on Public Charge

7. MLRI comments on proposed managed care regulations.

MLRI testified and offered written comments on the proposed amendments to 130 CMR 508.000, the MassHealth Managed Care Regulations, on October 3, 2025. Highlights of the testimony include urging MassHealth to reconsider a policy change excluding EAEDC recipients from managed care and to provide greater clarity in the regulations around HCBS waiver program participants’ rights to appeal. Find MLRI’s testimony here.