Healthcare Notes — Part 1: Massachusetts legislators take on high drug costs and the struggles of long-term care providers. 

Larry Pareles of IMC

by Larry Pareles, MD

(This is part one of a two-part overview of articles on Massachusetts healthcare issues.)

Healthcare remains on many minds as we start this new year. Our legislators are hearing some of the concerns and are trying to make some modest improvements.

Massachusetts has the highest percentage of people who are insured in the country, but we also suffer from high healthcare costs, limited access to care, a shortage of primary care and specialty caregivers, and a system that really isn’t meeting our healthcare needs. 

Single-payer universal healthcare insurance is still the best and only real way to pay for our healthcare, but here are two of the latest band-aid measures our legislature is weighing.

High drug prices are a serious problem.  

One area that clearly needs improvement is the very high cost of prescription drugs here and across the country.

Working to lower the very high cost of drugs, the Massachusetts Senate approved “An Act Relative to Pharmaceutical Access, Cost and Transparency” (“PACT 3.0″), although the House has not acted on it yet.  

Sen. Cindy Friedman (D-4th Middlesex), co-chair of the Legislature’s Joint Committee on Health Care Financing 

has worked on this legislation for years and the Senate finally passed the PACT 3.0 bill, which tries to hold drug companies accountable for drug price hikes, by a unanimous vote of 39-0.

Sen. Friedman said: “Two out of five people in the Commonwealth who have health insurance have difficulty accessing the care and medicines they need because of cost… We know that over 1.3 million people with diabetes are forced to ration their insulin, and over 70% of those people actually have health insurance.” 

“The urgent need to address all of this has never been greater… People simply can’t afford their health care anymore.” 

The PACT 3.0 bill has valuable provisions, including: 

  • Making insurers (including MassHealth, the state Medicaid program) cover generic medications for free and limiting the co-pays for brand-name medications to $25.
  • Providing financial aid for prescription drugs to treat chronic illnesses that disproportionately harm people of color.
  • Creating a licensure process for pharmacy-benefit managers to ensure they are meeting reasonable financial and organizational standards.

Where is the House on this legislation? Senator Friedman said she could not “presume” the likelihood of House action on the bill, but that she and Co-Chair House Rep. John Lawn “are on the same page.” Stay tuned for further action on this important bill.   

For details see these articles from MassLive and CommonWealth Beacon.

Long-term care providers are struggling.

Nursing homes and other long-term care facilities are struggling and some are closing permanently. The industry is grappling with staffing shortages, which became worse during and after the pandemic. The Massachusetts Senior Care Association did a survey that found most facilities were near capacity and had thousands of job vacancies.

House Democrats recently passed Bill H.4178, which has some reforms for the long-term care sector, to address weak infection-control plans, staffing shortages, and other problems in the senior care system.  

Massachusetts House speaker Ron Mariano said: “This comprehensive legislation will bolster the long-term care workforce, enhance oversight of facilities, and ensure greater access, all while prioritizing quality of care.”

The legislation creates a fund to pay for training of long-term care workers, and for capital improvements at nursing homes. It has new licensing regulations with more oversight, and lets regulators examine management’s criminal and civil litigation history, financial capacity, and history of providing long-term care here and elsewhere. It also increases penalties for non-compliance. 

Senate Democrats haven’t reported their plans about long-term care reforms, and legislative leaders seem to be on different pages about healthcare policy making, which has led to priority bills dying in recent years.For more details, see this article from State House News Service and this one from the Boston Globe.

Dr. Larry Pareles is a retired cardiologist living in Northampton, with more than 35 years’ experience in clinical medicine.