BOSTON – Massachusetts residents scrambling to find a primary care doctor may not see a legislative intervention for months — potentially after the November election.
House and Senate negotiators tasked with hashing out legislation aimed at pumping more money into the under-invested primary care sector and shoring up the workforce met for the first time Thursday, nearly seven weeks after the end of scheduled formal sessions. New joint rules this session enable the Legislature to take up conference committee accords well beyond July 31, meaning votes on closely watched bills could unfold during lame-duck sessions.
Health Care Financing Committee Co-chair Sen. Cindy Friedman, who’s leading the talks alongside House Ways and Means Chair Aaron Michlewitz, suggested there’s some leeway for reconciling the branches’ differing approaches to implement a new spending target for the sector and which health care entities must comply.
“We have till Jan. 4, and I hope we do it a lot sooner,” Friedman told the News Service when asked about her timeline for negotiators to reach an agreement.
Asked whether she has a goal of wrapping up talks before the election, the Arlington Democrat said, “We’re just starting. We want to do it, and we want to do it right, and that’s really what we’re focusing on.”
Conferees met publicly for about eight minutes Thursday afternoon, and Friedman said her staff has sent out section-by-section comparisons of the House and Senate bills.
Gov. Maura Healey, who is up for reelection in November, has repeatedly called on the Legislature to pass primary care reform as part of her administration’s broader focus on reining in soaring health care costs. On GBH’s “Boston Public Radio” on Wednesday, Healey talked about her efforts to boost investments in primary care and mental health “so that people have more access to these providers.”
“Most people need to just see a primary care or a mental health provider,” Healey said.
Friedman is operating without her Health Care Financing counterpart, Rep. John Lawn, after he did not deliver floor remarks on the primary care bill and was passed over for the conference committee assignment. Earlier this month, Friedman told the News Service, “yes I love John Lawn, and sorry he’s not on it,” while also voicing confidence about working with Michlewitz.
Michlewitz, asked how he ended up as the lead primary care negotiator for his branch, said House Speaker Ron Mariano called him and said, “I need you to chair this committee.”
“So obviously I accepted, and certainly not new to health care conversations,” Michlewitz told the News Service. “Obviously, in terms of not just the budget, but the economic development bills that we’ve negotiated, there’s certainly, obviously, plenty of health care discussion points that are involved in many of those debates and conferences. I don’t look at it as an unnatural place for me to be working at.”
Senate President Karen Spilka identified primary care reform as a priority on Jan. 1, 2025. But the branch did not unveil its proposal until this June, as it incorporated recommendations from a primary care task force led by the Executive Office of Health and Human Services and the Health Policy Commission.
The Senate passed its primary care bill (S 3141) June 18 on a 35-4 vote. After Mariano dismissed the Senate’s approach, the House unanimously passed its version (H 5630) July 30 with new guardrails on AI use.
From the Senate’s perspective, Friedman said Thursday that primary care reform is “really near and dear to our heart.”
“This is the moment, and if we don’t grab it, we’re just going to continue to see our health care system just decline to a point where people aren’t going to be able to access it or afford it,” Friedman said. “So, that’s the urgency.”
Friedman said lawmakers need to “make some big changes and make some entities uncomfortable.” She said the House and Senate bills “have a lot in common,” while noting there are a “couple big issues that we need to work together on to figure out.”
Michlewitz called primary care relief “long overdue.” The North End Democrat also sits on the conference committee for energy affordability legislation, which Healey has repeatedly urged lawmakers to get to her desk.
Michlewitz said that panel’s co-chairs have been speaking “extensively” since the end of July and that negotiators have “a long way to go” to reach an agreement. Conferees met for the first time on July 29.
“I mean, obviously, I think we’d all like to see it done as quickly as possible because there’s….in both bills there’s versions of some real immediate savings that I think we want to try to help deliver to our constituents,” Michlewitz said. “But there’s some large differences in how to get there and there’s some large differences in how to move forward. And so I do think we still have a long way to go — a lot of work to do.”
[Katie Castellani contributed reporting.]