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Health Policy Commission approves 2025 cost trends report, urges statewide convening to tackle affordability
Summary
The Health Policy Commission voted to issue its 2025 health care cost trends report, urging a statewide convening and focused reforms on administrative complexity, health care prices, pharmaceutical spending and low-value care. Commissioners debated prior authorization language and next steps for implementation.
The Health Policy Commission voted to issue its 2025 health care cost trends report, advancing a package of recommendations that prioritizes administrative simplification, action on health care prices, controls on pharmaceutical spending and efforts to reduce low-value or avoidable care.
Executive Director David South opened the public discussion by summarizing panels from the commission's recent cost trends hearing and urging action. South said the attorney general’s message at the hearing captured the tenor: "business as usual is not working. Patients as a result are suffering," framing the report as a call to convene stakeholders to build a consensus set of reforms.
Why it matters: the commission said accelerating premium trends, the prospect of federal policy changes that could reduce coverage, and stress on safety-net providers together create an inflection point for affordability and access. The report highlights that hundreds of thousands of residents who purchase coverage through the Connector could face higher premiums absent federal action and that community health centers and high-public-payer hospitals face heightened financial risk.
What the report does: rather than a long laundry list, the draft report focuses on four priority areas for the 2026 policy agenda: administrative complexity (including a review of prior authorization practices), health care prices as an input to premiums, pharmaceutical spending and strategies to curb low-value care while investing in high-value services and workforce. Staff noted new statutory tools and data available from legislation enacted earlier in the year, including creation of an Office of Pharmaceutical Policy and Analysis and an Office of Health Resource Planning within the agency.
Commissioner reaction: commissioners voiced broad agreement about the need for change but debated phrasing and emphasis. Commissioner Cohen called the hearings "the most provocative" she had attended, urging clear recommendations; other commissioners emphasized equity in program reach (noting hospital-at-home enrollment should track barriers such as transportation and disability), and differing views surfaced over prior authorization—some framed it as an administrative burden that can be streamlined, while others warned that removing it entirely could raise premiums or remove clinical oversight.
Vote and next steps: a commissioner moved and a second followed to accept the recommendations as written for public issuance; the commission approved the issuance by voice vote. The report text will be released and the commission signaled it stands ready to support and participate in follow-on convenings, to advance implementation through newly established offices and task forces, and to use its planning authorities to inform delivery-system reforms.
The public meeting concluded with staff updates on upcoming publications (including a behavioral health workforce center assessment planned for early 2026) and the commission voted to enter a confidential executive session for the remainder of the agenda.
