Flanked by health care leaders of color on the State House steps, Sen. Liz Miranda framed her health equity reform omnibus legislation Tuesday as the “only beautiful bill that exists” and as an antidote to the federal megalaw that is expected to cause Medicaid upheaval.
“This bill is about building a system that truly works for everyone: Black mothers, Hispanic seniors, white Back Bay residents, and immigrants, regardless of their documentation status,” Miranda said at the rally.
There’s a 23-year difference in life expectancy between Nubian Square residents in her district, which includes Roxbury, and those living two miles away in Back Bay, Miranda said.
“With the recent cuts to Medicaid slated to hit Massachusetts in the coming months, they will disproportionately affect people of color, and it will worsen health disparities,” the Boston Democrat continued. “There’s no time left to pass this bill. Now is the time because people will die.”
Hundreds of thousands of Bay Staters who are insured through MassHealth or Massachusetts Health Connector plans are expected to lose coverage under the “big beautiful bill” that President Donald Trump signed into law earlier this month. Massachusetts stands to lose $3.5 billion in federal funding over the next decade.
“We cannot continue to allow systemic inequities and historic barriers to limit who benefits from the care our hospitals have to offer,” Miranda said.
Advocates cheered as Miranda spoke and held up posters that read, “Protect Medicaid” “Defend Medicaid,” “Black Health Matters” and “MA Will Protect What DC Won’t.”
The rally Tuesday morning came before a Health Care Financing Committee hearing that included the proposal Miranda filed with Sen. Pavel Payano (S 901) and the accompanying House bill (H 1416) from Reps. Bud Williams and Judith Garcia. Payano and Garcia are members of the panel.
The legislation cleared the HCF Committee last session but died in the Senate Ways and Means Committee. Supporters say some provisions still managed to pass through other legislative vehicles last session, including the economic development, prescription drug reform and hospital oversight laws.
Backed by the Health Equity Compact that’s comprised of more than 85 leaders of color, the refiled legislation would create a Cabinet-level Executive Office of Equity, set statewide health equity goals, require standardized health equity data metrics across providers and payer organizations, and invest in a diverse health care workforce. The proposals would also remove immigration status as a barrier to MassHealth coverage; expand access to community health workers, patient navigation and interpreter services; and require that certain telehealth services be reimbursed at the same rate as in-person visits, according to the compact.
In a statement, Lora Pellegrini, CEO of the Massachusetts Association of Health Plans, expressed insurers’ commitment to addressing health inequities and thanked the compact for “its leadership in advancing meaningful reform.”
Pellegrini urged lawmakers to be cautious about advancing the full omnibus bill and potentially raising health care costs as looming federal cuts “threaten to undermine the state’s Medicaid program and reduce access to care for the very communities these reforms aim to support.”
“For example, mandating telehealth payment parity across the board would increase costs for both consumers and employers. We believe the market is already evolving to meet patient needs, with some plans reimbursing at in-person rates and others using alternative payment models that maintain access while promoting cost efficiency,” Pellegrini said. “We also share the Compact’s commitment to strengthening investments in primary care and behavioral health, but these investments must be aligned with the state’s cost growth benchmark to ensure they are sustainable over the long term.”
At the start of the hearing, committee co-chair Sen. Cindy Friedman called the complexity of the health care system “out of control.” The Arlington Democrat acknowledged the “enormous gaps” that exist in accessing care depending on residents’ income, the increasing volume of residents becoming uninsured or underinsured, and financial insecurity across hospital systems.
“It is abundantly clear that a health care system that is less and less affordable and accessible, that is driving away providers at an alarming rate when most really do want to provide health care, and at the same time where cost continues to rise at a dizzying pace cannot, nor will it ever be, an equitable system where everyone can receive the care they need when they need it,” Friedman said. “It frankly cannot be a system that can be sustained, let alone equitable.”
Health inequities among Black, Hispanic/Latino and Asian communities cost Massachusetts about $5.9 billion each year, according to a 2023 report from the Blue Cross Blue Shield of Massachusetts Foundation.
Friedman, who later said the 45-page health equity bill has “wonderful stuff in it,” pressed a panel of health care leaders to identify three core components of the legislation.
Michael Curry, CEO of the Massachusetts League of Community Health Centers, pointed to provisions surrounding data tracking, setting health equity benchmarks and workforce development.
“Workforce is, for those of us who are football fans, a fourth-quarter strategy,” Curry, who co-founded the compact, said at the hearing in Gardner Auditorium. “You can focus on many things, but if you get a provider who knows communities with lived experience to be in all these critical positions, if you can invest — because you have to start that now, so that young person that’s in the back of the room can be that physician we need them to be in four to six or seven or eight years to then save lives in a way we need them to.”
Amy Rosenthal, executive director of Health Care For All, had highlighted the provision bolstering health care access for immigrants.
“Immigrants in Massachusetts are often forced to rely on a complex patchwork of safety net programs for health care, and even this is under threat with the new HHS order that just came down,” Rosenthal said, referring to a July 10 action from the U.S. Department of Health and Human Services to block immigrant access to certain federal public health benefits, including Head Start. “Eliminating immigration as a barrier to MassHealth coverage would help more people live safe and healthy lives regardless of their immigration status.”
When times are “really bad,” Friedman said, policymakers must focus on keeping people safe and healthy.
“We have an enormous crisis here,” Friedman said, without referencing a specific part of the bill. “What we can do in terms of immigration will fall on our backs, and we will pay a big price for it. And I’m not saying we shouldn’t, but we have all of these things coming at us.”
Amid federal turbulence and shifting vaccine recommendations under HHS Secretary Robert Kennedy Jr., public health leaders are worried about the possibility of “backsliding on health and health equity,” said Oami Amarasingham, deputy director of the Massachusetts Public Health Alliance. MPHA and other medical societies sued Kennedy and HHS last week over changes to COVID-19 vaccine guidance.
“No matter what happens in D.C., Massachusetts must stand up for public health,” Amarasingham said at the rally. “Massachusetts must invest in prevention and in equity, and Massachusetts must double down on racial justice. And we can do that by passing an act to advance health equity.”
Find the article here.