Delaware Policy Leaders Take Aim at Primary Care Reform, Health Care Affordability

Legislative Leaders and Insurance Commissioner announce Senate Bill 1

DOVER, DE (March 5, 2026) - Health policy leaders in Delaware unveiled Senate Bill 1 today, which aims to put patients and providers first by rebalancing the healthcare dollar and enhancing access to high quality, affordable care. This bold proposal builds off of the Department of Insurance's implementation of prior law, which invested more than $203M in primary care from 2022-2025. Even while continuing investments in primary care, Senate Bill 1 could conservatively save a cumulative $282M over the first five years of full implementation across state-regulated health plans and enrollees.

"For more than a decade, Delaware has outpaced the nation in health care cost growth, without corresponding results in the health of residents. The affordability provisions in Senate Bill 1 could save more than $50M per year, lowering premiums across State and commercial plans while investing in the care that improves health and drives down costs long-term. Premiums are higher than ever due to Congressional inaction and Delaware's high health care costs - there is no time to waste," said Insurance Commissioner Trinidad Navarro.

Delaware is the state struggling the most with primary care provider shortages, with just 16.36% of need met according to Becker's Healthcare. Primary care plays a central role in prevention of costly care, chronic disease management, and health equity. As recently reported by Millbank, having a usual source of primary care was associated with having nearly 54% lower total health care expenses for adults with chronic disease.

"As part of our ongoing efforts to make healthcare affordable for all Delawareans, we need to address both recently inflated costs, and long-term trends in both outcomes and price," said Senate Majority Leader Bryan Townsend.

"More and more, we see employer plans cut benefits instead of cutting costs through addressing health outcomes and health care prices. If commercial plans throughout the state take up models similar to Senate Bill 1, cumulative savings could be up to $442.7M and Delaware would no longer be the second most expensive state for employer-based health insurance premiums," said House Health and Human Development Committee Chair Nnamdi Chukwuocha.

More than half of U.S. adults reported that their health care costs have increased in the past year, making it their top financial concern according to a KFF poll. The legislation's improved health outcome savings, coupled with reasonable cost containment strategies fully fund its mandated primary care investments. Savings brought forward by the legislation are owned by the health plans, employers, and policyholders, and cannot be retained by insurers given medical loss ratio standards. The Department of Insurance will assess savings as part of the rate review process to negotiate lower premiums.

By stabilizing and strengthening primary care, the bill aims to reduce avoidable emergency care, hospitalizations, and long-term chronic conditions. Addressing both use and cost are key to savings, as relative to Medicare, Delaware ranks No. 7 nationally for highest inpatient prices and No. 4 for highest outpatient hospital costs according to RAND reports. Hospital inpatient services are the largest share of Delaware's health care spending, and hospital outpatient services are the third largest. These costs have grown more than 300% over the last 20 years, whereas the national average is closer to 150% and neither annual inflation nor median household income have reached 50% growth at the same time.

This legislation aligns squarely with Governor Matt Meyer's stated goals of improving health care affordability and access for all Delawareans, while strengthening the foundation of our health care system - primary care - where better outcomes, and lower costs, begin. Governor Meyer's historic Rural Health Transformation Program effort will meaningfully invest in helping rural health care providers and federally-qualified health centers shift to the more sustainable payment models of value-based care, including through integration new technology and collaboration. Senate Bill 1 will build upon this bold effort to enhance provider readiness by ensuring ample opportunity exists in all forms of insurance contracting and ensuring current efforts do not sunset.

When reviewed by the nonpartisan impartial experts within Center for Advancing Health Policy through Research at Brown University they calculate Delaware employers, health plans, and policyholders could save approximately $442.7M annually with Senate Bill 1 in effect if adopted across the commercial market. With carriers gaining experience in value-based care and cost containment practices through the implementation of legislation, leaders are hopeful that insurers and companies will consider expansion of the approach into plans the state law does not control.

"Delaware has the seventh-highest hospital prices in the nation. Those high prices translate directly into higher premiums and out-of-pocket costs for residents, making it harder for families to afford the health care they need," said Roz Murray, an assistant professor of health services, policy and practice at the Brown University School of Public Health, who modeled the anticipated commercial savings from the legislation's cost containment strategy. "We commend Delaware's leaders and the Department of Insurance for exploring research-backed, systemic solutions to improve health care affordability for all Delawareans."

Without this legislation, Delaware's public policy efforts around primary care would sunset, making the state the first in the nation to go backwards on investments, value, and affordability efforts.

Physicians across the state support Senate Bill 1

The legislation received early endorsements from health care providers and groups throughout the state.

"The Medical Society of Delaware (MSD) has been a consistent advocate for comprehensive primary care reform and is proud to have contributed to the policy framework that has advanced these efforts statewide. We recognize the continued leadership of the Delaware Department of Insurance and Senate Majority Leader Bryan Townsend in introducing Senate Bill 1 (SB1), which represents a meaningful step forward in strengthening Delaware's healthcare delivery system.

SB1 reflects key policy priorities long supported by MSD, including sustainable primary care investment, workforce stabilization, and payment reform measures designed to ensure long-term viability of community-based practices. By reinforcing these structural supports, the legislation will help safeguard access to high-quality, affordable primary care services for Delawareans and promote a more resilient healthcare system overall," said Brian J. Galinat, MD, MBA, President of the Medical Society of Delaware.

Senate Bill 1 has been assigned to Senate Health & Social Services committee, to follow along, and view the bill visit Legis.Delaware.gov

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