Transcript Highlights:

• Today, it is estimated that 70 to 80% of all ABA services in the state are funded by MassHealth.
• BCaBAs as a recognized mid-level supervisory role within the MassHealth reimbursement framework.
• The new 2026 MassHealth ABA policy is a clear example of why this matters.
• MassHealth coverage allows us to serve families who would otherwise have no access to care.
• ABA is the only treatment for autism and now Down syndrome recognized and covered by MassHealth.

Bills: H4353, H4425, H4453, H4623, H4770, S2587, S2737

Keywords: behavioral health, Medicaid, reimbursement rates, healthcare providers, service delivery, accreditation, Medicare, end-stage renal disease, healthcare access, patient coverage, renal failure, MassHealth, asset limit, personal vehicle exemption, vehicle value, healthcare, autism, ABA services, assistive technology, children

Summary: The Joint Committee on Health Care Financing held a public hearing on several health care financing bills, with most testimony focused on autism/ABA services and kidney disease coverage. On House Bill 4623, Representative Lisa Field and providers from Community Autism Services and related groups urged the committee to recognize assistant-level ABA providers, including BCaBAs, in the MassHealth reimbursement structure to expand capacity, reduce wait lists, and improve access for children with autism. An actuary testified that moving from a two-tier to a three-tier ABA model could lower MassHealth costs, and providers said current reimbursement and new MassHealth requirements are contributing to long delays and workforce strain. On House Bill 4353 and Senate Bill 2587, testimony from ABA organizations supported a biannual Medicaid rate review process to better align reimbursement with service costs, workforce needs, accreditation requirements, and new administrative burdens, without mandating a specific rate increase.

Transcript Highlights:

• MassHealth told them to. MassHealth said, you've got to at least pay what we're paying.
• Maintaining adult dental MassHealth benefits and ensuring access to dental Maintaining adult dental MassHealth
• More than 80% of these patients are MassHealth, and I am a proud MassHealth dental provider.
• She was on MassHealth. She was treated after she was on MassHealth.
• from MassHealth, and they stopped.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket of bills focused on MassHealth benefits and reimbursement, health equity, behavioral health, public health, dental access, 340B drug pricing, tobacco cessation, and coverage for children. The chairs emphasized rising health care costs, provider shortages, administrative burdens, and persistent inequities by income, race, geography, and immigration status. Much of the testimony centered on H.1416/S.901, an act to advance health equity, with legislators and members of the Health Equity Compact arguing for statewide benchmarks, stronger health equity leadership, reimbursement for interpreter services, community health workers and patient navigation, Medicaid graduate medical education support, and a health equity zone trust fund. Witnesses described disparities in life expectancy, maternal mortality, access to primary care, and the impact of federal Medicaid and social service cuts, and urged the committee to report the bill favorably. The committee also heard strong support for H.1368/S.847 on rapid whole genome sequencing for critically ill MassHealth children. Testifiers from industry, academia, hospitals, and families said early sequencing can end long diagnostic odysseys, improve treatment decisions, shorten hospital stays, and save money, while also providing emotional relief and information for families. The hearing then moved to H.1407 on MassHealth rate parity for inpatient behavioral health providers, where Rep. Scanlan and the Massachusetts Association of Behavioral Health Systems said the bill would codify existing administrative parity so managed care plans cannot pay less than the MassHealth fee-for-service rate. On H.1392/S.853 to preserve and protect public health, witnesses supported higher vaccine administration fees to improve provider participation and immunization rates. The committee also heard testimony on H.770/845 to protect 340B providers in MassHealth, and on S.848 to require reporting and transparency around 340B revenues and outside administrative costs. Additional bills drew testimony on tobacco cessation coverage for MassHealth members, with advocates supporting broader access to counseling and medications through medical, behavioral health, and dental providers. On H.1409, a nursing home operator asked for more flexibility in a MassHealth staffing-related penalty tied to patient days per resident. On H.1401/S.888, supporters of the “Take 10” dental access proposal said adult MassHealth dental coverage is underused because too few dentists accept MassHealth, leading to long travel times and avoidable emergency room visits; they urged incentive payments for dentists serving new adult MassHealth patients. Finally, on H.1403/S.855, “Cover All Kids,” advocates and immigrant community members urged removal of immigration status as a barrier to full MassHealth coverage for children, while also backing a related bill to ensure 12 months of continuous coverage for children. No votes were taken during the hearing; the committee primarily received testimony and asked questions on costs, reimbursement levels, and implementation details.

Transcript Highlights:

• This legislation does not set rates for MassHealth or EHS.
• Current MassHealth reimbursement does not reflect the actual cost.
• MassHealth would cover the rest of the six months.
• Jones to be able to qualify for similar MassHealth services as Mr.
• Her gross income exceeded the MassHealth deductible threshold.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing focused on two broad sets of issues: home- and community-based care, and school-based Medicaid reimbursement. In the morning session, legislators and advocates testified on bills affecting children and disabled enrollees, including proposals to clarify rate-setting for home health and home care services (H. 767/S. 870), allow family members and spouses to be paid caregivers under MassHealth (H. 1394/S. 886 and related bills), extend MassHealth coverage for applied behavior analysis and other therapies beyond age 21 for adults with autism and developmental disabilities (H. 1351/S. 871), and protect medically fragile children by improving access to continuous skilled nursing. In the later portion of the hearing, testimony shifted to a bill to improve MassHealth reimbursement for schools (S. 862), with speakers describing the school mental health crisis and the need to reinvest Medicaid funds directly into school health services. Witnesses on the home care rate-setting bill said current reimbursement methods are opaque and outdated, contributing to workforce shortages, unfilled shifts, long waitlists, and patients remaining in hospitals longer than necessary. Home care providers and trade groups argued the bill would not set rates directly but would require more transparent methodology and fuller consideration of real costs such as wages, benefits, taxes, training, and technology. On caregiver bills, many family members and provider organizations described the financial and emotional strain of caring for disabled or medically fragile relatives, especially when parents, spouses, or guardians are barred from being paid caregivers. They argued the bills would recognize existing unpaid care, help families remain at home, and reduce reliance on more expensive institutional care. Advocates for adult ABA coverage said services remain medically necessary after age 21 and that ending coverage at that age creates an inequitable “cliff” for MassHealth members compared with those with private insurance. For the PACE/community care bill, elder law attorneys and PACE advocates said current MassHealth income rules force some older adults with modestly higher incomes to spend down to $542 per month, making community living unrealistic and pushing people toward nursing homes. They supported changing the eligibility structure to a premium-based approach that would allow more people to remain in the community. On the school Medicaid bill, advocates said schools are providing effective, preventive mental health care, but reimbursement currently flows to municipalities rather than directly back to school health budgets, limiting districts’ ability to hire and retain staff. No votes were taken during the hearing; the committee heard testimony and several witnesses requested favorable reports on the bills.

Transcript Highlights:

• It was a very democratic group in MassHealth.
• for MassHealth to authorize retroactive MassHealth coverage is going to shift.
• And MassHealth and Massachusetts are not unique, right?
• You know, MassHealth is already, you know, a $22 billion program.
• So they make too much money for MassHealth.

Keywords: 1212, all

Summary: The Long-Term Services and Supports and Health Equity Subcommittee met with roll call, approval of prior minutes, and a presentation from Leslie Darcy, chief of LTSS at MassHealth. The main discussion focused on the Personal Care Attendant (PCA) working group, which had completed its legislatively mandated review and submitted recommendations. Darcy said several earlier recommendations were already implemented, including reinstating the 66-hour overtime cap, strengthening program integrity efforts, and removing paperwork-related authorized hours for EVV users. The group then reached consensus on additional recommendations to reduce the overtime cap from 66 to 60 hours, set a seven-hour weekly meal-prep support limit, and continue work on benchmarks, though no consensus was reached on a benchmark standard. Darcy said the proposed changes were intended to preserve program integrity while addressing rapid cost growth in PCA services. Darcy also reviewed the expected effects of a recent federal Medicaid-related bill, estimating that Massachusetts could lose about $3.5 billion by January 2028. She described upcoming changes affecting Medicaid eligibility for certain immigrant groups in October 2026, work requirements for some non-disabled adults beginning in January 2027, six-month redeterminations for certain adults, and shorter retroactive coverage periods. She emphasized that people with disabilities and people on Medicare would be exempt from the new work requirements and six-month redeterminations. Members asked about the impact on community hospitals, the health safety net, and ACA premium subsidies; Darcy said federal changes could worsen uncompensated care pressures, but Massachusetts used state funds to offset the loss of enhanced ACA premium tax credits, helping keep premiums lower for middle-income families. In response to questions about the FY27 budget, Darcy said MassHealth expected targeted reductions, some one-time measures, and likely a rate freeze rather than large base cuts, with further cost-containment work to follow in FY28. She noted that LTSS is a major share of MassHealth spending and that programs such as PCA, adult foster care, and adult day services are state-plan entitlements once adopted by the state, even though the federal government does not require them. Charlie Carr and other members stressed that the PCA work group had been difficult but collaborative, and Carr said the recommendations were modest compared with other options considered. The meeting ended with a brief planning discussion about a February guest presentation from the Department of Public Health and a motion to adjourn, which was approved.

Transcript Highlights:

• It was a very democratic group in MassHealth.
• And MassHealth and Massachusetts are not unique, right?
• You know, MassHealth is already, you know, a $22 billion program.
• You know, MassHealth is already, you know, a $22 billion program.
• So they make too much money for MassHealth.

Keywords: 995, all

Summary: The subcommittee opened with roll call and approved the November 2025 minutes. Commissioner Charlie Carr then introduced Leslie Darcy, chief of LTSS at MassHealth, who provided an update on the PCA working group and on federal and state budget pressures affecting MassHealth and long-term services and supports. Darcy said the PCA working group had completed its work and submitted recommendations, including reinstating the 66-hour overtime cap, strengthening program integrity, and ending paid paperwork time for EVV users; she said those changes were implemented on 11/26 and were expected to save $7.4 million. She also described additional consensus recommendations to lower the overtime cap from 66 to 60 hours, create a seven-hour weekly meal-prep support limit, and continue exploring benchmarks, though the group could not reach consensus on a benchmark standard. Darcy warned that a federal bill enacted about six months earlier would significantly affect MassHealth, with an estimated $3.5 billion loss to the Commonwealth by 2028. She outlined upcoming changes including revised immigrant eligibility rules in October 2026, work requirements for certain non-disabled adults beginning in January 2027, six-month redeterminations for some adults, and shorter retroactive coverage periods. In response to questions, she said people with disabilities and Medicare beneficiaries would be exempt from the work and six-month redetermination requirements. She also explained that reduced federal ACA subsidies were being offset in Massachusetts by state spending, including $250 million in additional state support to keep premiums lower for middle-income families. Members raised concerns about community hospitals, the health safety net, and the impact of federal funding changes on provider rates and uncompensated care. Darcy said restrictions on provider taxes would limit MassHealth’s ability to use those revenues to support rates, and she noted a current $300 million shortfall in the health safety net. She said FY27 would likely include a rate freeze, targeted reductions, one-time budget measures, and further work groups to examine programs such as adult foster care, which she said had grown 40% in two years. Carr emphasized that the situation was serious but potentially fluid, and the meeting ended with no further business; the subcommittee agreed to adjourn before the next meeting and noted an upcoming February presentation from the Department of Public Health.

Transcript Highlights:

• So the first was that MassHealth should enforce the overtime cap at 66 hours.
• or the MassHealth program in the aggregate, Within MassHealth or the MassHealth program in the aggregate
• In state fiscal year 24, MassHealth spent $71 million on overtime.
• In state fiscal year 24, MassHealth spent $71 million on overtime.
• And, you know, if you think about MassHealth generally, MassHealth as a program, like the big MassHealth

Keywords: 995, all

Summary: The subcommittee met with MassHealth LTSS Chief Leslie Darcy to review the Personal Care Attendant (PCA) program and the legislative work group focused on its long-term sustainability and cost containment. Darcy and Charlie described the work group’s five meetings and three consensus recommendations: enforce the 66-hour overtime cap, address fraudulent activity in the PCA program, and eliminate MassHealth handling of PCA paperwork/administrative work for members without a live-in exemption because those members are subject to EVV. They explained EVV as an electronic visit verification system replacing paper timesheets, and noted the rollout is expected to be completed this fall. The group estimated about $7 million in savings from the consensus recommendations and agreed to continue meeting through June to consider additional ideas. Darcy presented data showing the PCA program served about 56,000 members in state fiscal year 2024 and has grown from $1.2 billion in FY20 to $1.6 billion in FY24, with projections near $2 billion by 2027. She said much of the growth is driven by wage increases and older adults using more services, and compared PCA costs with other LTSS programs. The discussion also covered overtime spending, the role of federal financial participation, and how Massachusetts’ PCA program differs from other states because it has no hard caps on hours or activities. Several members emphasized the program’s value for independent living and community participation, while also acknowledging the need to control growth without undermining services. Members asked about undocumented immigrants and MassHealth funding, and Darcy explained that some eligibility categories are state-funded only and do not receive federal matching funds. Another member asked about workforce recruitment and wage pressures; Darcy said recent collective bargaining agreements raised PCA wages, with some workers eventually reaching $25 per hour and the entry wage reaching $20. The group also discussed whether IADL hours are disproportionately high compared with ADL needs, and reviewed data suggesting potential savings if IADL hours were limited relative to ADL hours, though no consensus recommendation was made on that point. The meeting ended with approval of the prior minutes by roll call vote, an update that the next health equity informational hearing is scheduled for May 19, and a motion to adjourn carried unanimously.

Transcript Highlights:

• Today, it is estimated that 70 to 80% of all ABA services in the state are funded by MassHealth.
• The new 2026 MassHealth ABA policy is a clear example of why this matters.
• The new 2026 MassHealth ABA policy is a clear example of why this matters.
• MassHealth coverage allows us to serve families who would otherwise have no access to care.
• MassHealth coverage allows us to serve families who would otherwise have no access to care.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on several health care bills focused primarily on autism services and kidney disease coverage. Committee chairs John Lawn and Cindy Friedman opened by outlining hearing procedures, testimony rules, and filing deadlines, and noted the hearing would be recorded and written testimony accepted. They said the day’s topics included affordability and access to behavioral health services, provider reimbursement, Medicare coverage for vulnerable populations, and MassHealth eligibility asset exemptions. A major portion of the hearing concerned House Bill 4623, which would add board-certified assistant behavior analysts (BCABAs) as a recognized mid-level supervisory role in the MassHealth reimbursement framework to help address long wait lists for autism spectrum disorder services. Representative Lisa Field, actuaries, clinicians, and autism service providers testified that the current two-tier model limits workforce capacity, contributes to long delays, and leaves families waiting months for care. Supporters said the bill could expand access, improve retention, and potentially reduce MassHealth costs, while also helping providers meet growing demand and new administrative requirements. The committee also heard testimony on House Bill 4425 and Senate Bill 2737, which would allow Massachusetts residents under 65 with end-stage renal disease to purchase Medigap coverage. Legislators, dialysis advocates, and patients described high out-of-pocket costs under Medicare, barriers to kidney transplant eligibility without secondary insurance, and the financial strain on patients and families. Testifiers said the change would affect about 846 residents, could modestly increase premiums, and might reduce Medicaid spending by preventing asset spend-downs. Senator Gomez and others spoke from personal experience with dialysis and transplant care. Finally, the committee heard testimony on House Bill 4353 and Senate Bill 2587, which would require regular data-driven review of MassHealth ABA reimbursement rates. Providers and association representatives argued that reimbursement has not kept pace with inflation, workforce shortages, accreditation costs, and new 2026 MassHealth policy requirements, and said the bills would improve transparency and ensure rates reflect the true cost of care. No votes were taken; the hearing concluded with the chairs thanking participants, inviting additional written testimony, and adjourning the meeting.

Transcript Highlights:

• All poor people do not have MassHealth.
• But this must extend beyond MassHealth.
• It's House 1289, and what the bill would do would require that MassHealth, MassHealth carve-outs, and
• Since 2024, my practice has served over 200 MassHealth members.
• Gratefully, MassHealth has addressed this by covering doula services.

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with testimony on a wide range of health insurance and access-to-care bills. Early testimony focused on prescription drug pricing and pharmacy reimbursement, with supporters of H. 1326 arguing that pharmacy benefit managers and MassHealth managed care arrangements reimburse independent pharmacies too little, contributing to pharmacy closures and “pharmacy deserts.” The committee also heard repeated support for H. 1151/S. 742 on cognitive rehabilitation for acquired brain injury, H. 1288/S. 716 on telehealth parity for nutrition counseling, H. 1309/S. 761 on full-spectrum pregnancy care without cost-sharing, H. 1312 on insurance coverage for doula services, H. 309 on prompt access to health care by removing deductibles for certain services, H. 809/H. 1227 on biomarker testing, H. 1162/S. 810 on reducing inequities in access to medical procedures by limiting insurer cuts tied to Modifier 25, and S. 726 on insurance coverage for mobile integrated health. Testifiers included legislators, physicians, pharmacists, dietitians, emergency and rehabilitation clinicians, and patients and family members. Supporters of the brain injury bill said cognitive rehabilitation is medically necessary, improves long-term outcomes, and can reduce institutional care and public costs; they noted the bill has been heard repeatedly and has support from the Brain Injury Commission and prior favorable committee action. Supporters of the pregnancy care and doula bills described out-of-pocket costs as a barrier to maternal health and shared personal stories of high bills and unmet support needs. Biomarker testing advocates and cancer patients said coverage gaps deny patients access to precision treatment, can lead to avoidable suffering, and should be standardized across insurers; several speakers said insurers often deny claims despite clinical benefit. Dermatology witnesses said insurers’ use of Modifier 25 cuts reimbursement for same-day evaluation and procedure visits, forcing separate appointments and increasing patient burden. Mobile integrated health supporters described home-based care as a way to reduce emergency department use and hospital readmissions, especially for patients with transportation or mobility barriers. No votes or formal committee actions were taken during the hearing itself.

Transcript Highlights:

• Today, it is estimated that 70 to 80% of all ABA services in the state are funded by MassHealth.
• BCABAs as a recognized mid-level supervisory role within the MassHealth reimbursement framework.
• The new 2026 MassHealth ABA policy is a clear example of why this matters.
• MassHealth coverage allows us to serve families who would otherwise have no access to care.
• ABA is the only treatment for autism and now Down syndrome recognized and covered by MassHealth.

Summary: The Joint Committee on Health Care Financing held a public hearing on a range of health care financing bills focused largely on autism services and kidney disease coverage. Committee chairs John Lawn and Cindy Friedman outlined hearing procedures and noted that written testimony would continue to be accepted until each bill is acted upon. They said the day’s bills addressed affordability and access to behavioral health services, provider reimbursement, Medicare coverage for vulnerable patients, and MassHealth eligibility asset exemptions. A major portion of the hearing concerned House Bill 4623, which would recognize board-certified assistant behavior analysts (BCABAs) in the MassHealth reimbursement framework to help address long wait lists for autism spectrum disorder services. Representative Lisa Field and several providers testified that Massachusetts families face long delays for ABA services and that adding BCABAs would expand workforce capacity, reduce costs, and improve access. Wakely actuary Annie Tasman Ewing said a three-tier model could reduce MassHealth costs by up to 6% annually, while Dr. Sandra Beaton and others described severe wait lists and said the bill would allow more families to be served sooner. The committee also heard extensive testimony on House Bill 4425 and Senate Bill 2737, which would allow people under 65 with end-stage renal disease to purchase Medigap coverage. Representative Stanley, Senator Gomez, and advocates from the American Kidney Fund and Dialysis Patient Citizens argued that current law unfairly excludes these patients, leaves them with high out-of-pocket costs, and can delay transplant eligibility because many centers require secondary insurance. Testifiers said the change would help about 846 residents, could cost insurers only a small premium increase, and might reduce Medicaid spending by avoiding asset spend-downs. Committee members asked questions about the existing statutory carve-out and the practical effects on transplant access. The hearing also included testimony on House Bill 4353 and Senate Bill 2587, which would require regular Medicaid rate reviews for ABA services. Providers and clinicians said current MassHealth rates no longer reflect the cost of delivering care, especially with new 2026 policy requirements, workforce shortages, and accreditation obligations. They emphasized that the bills would not mandate a rate increase but would create a data-driven, transparent review process. At the end of the hearing, the chairs thanked participants, invited additional written testimony, and the committee voted unanimously to adjourn the hearing.

Transcript Highlights:

• MassCACs, so MassHealth Community Application Counselors, so that we can enroll people directly in MassHealth
• or renew their MassHealth that's been suspended.
• And so we now can enroll people directly in MassHealth.
• MassHealth had to really respond in Four Health Consulting... And MassHealth had to really respond.
• And then we're working on MassHealth.

Keywords: 995, all

Summary: The Special Commission on Correctional Consolidation and Collaboration met to approve the May 5 minutes and hear a presentation from the Massachusetts Probation Service. The minutes were approved unanimously, with a request that a member’s closing remarks be added to the record. The commission also noted online participants and confirmed quorum before moving to the presentation. Probation leaders described the agency’s role as the state’s largest post-release supervision system and emphasized its focus on reentry, accountability, and reducing technical violations. They outlined the from-and-after sentencing structure, dual supervision with parole, and efforts to reduce revocations and non-criminal violations. Members asked about racial and ethnic disparity work, and probation said that effort is funded through the trial court and state budget, not federal grants. The presentation highlighted community engagement, simplified and translated probation conditions, workforce diversification, and training aimed at improving trust and access for court users. A major portion of the discussion focused on Community Justice Support Centers, evidence-based programming, and shared services such as housing, MassHealth enrollment, transportation, and behavioral health referrals. Probation said the centers are underutilized but have shown improved outcomes in non-randomized studies, with lower recidivism among participants compared with similar probationers. Members discussed mental health access, veterans identification, medication-assisted treatment, and the importance of state IDs and driver’s licenses for successful reentry. The commission also heard about housing supports, including transitional and sober housing, and a statewide behavioral health initiative for justice-involved individuals. The meeting ended with plans for the next session on July 11 and a motion to adjourn, which passed.

Transcript Highlights:

• MassHealth, for those who may not know, is not Medicare.
• The largest expenditure in the state of Massachusetts is MassHealth.
• So this current 1115 waiver, MassHealth has a very specific goal to advance health equity for MassHealth
• Incentive Program is a $2 billion initiative by MassHealth.
• With this measure, MassHealth is requiring entities to train staff.

Keywords: 995, all

Summary: The Massachusetts Permanent Commission on the Status of Persons with Disabilities held a public hearing focused on health equity for people with disabilities. The chair opened by explaining that the session was not about specific legislation, but about sharing data, lived experience, and strategies to inform more inclusive health systems. Presenters included representatives from the Health Equity Compact, the Department of Public Health, MassHealth, UnitedHealthcare Community Plan, the Brain Injury Association of Massachusetts, UMass Chan Medical School, Spaulding Rehabilitation, and the Arc of Massachusetts/Operation House Call. Speakers described how structural racism and ableism contribute to poor health outcomes, unemployment, poverty, and barriers to care for disabled people, especially disabled people of color. Testimony highlighted access problems such as inaccessible medical equipment, transportation, inadequate provider training, lack of culturally competent care, and insurance barriers. Several speakers emphasized the importance of collecting and disaggregating disability data, training providers in disability-competent care, and screening for accommodation needs. MassHealth described its Quality and Equity Incentive Program under the 1115 waiver, including disability-related metrics on data completeness, staff training, and accommodation screening, and reported early increases in hospitals collecting self-reported disability data. Brain injury advocates focused on inequities in rehabilitation access, including the impact of CMS’s “three-hour rule,” which they argued denies needed inpatient rehab to people with severe traumatic brain injury. They called for policy changes, a TBI task force, and possibly bipartisan legislation if CMS cannot revise the rule. Other testimony described DPH efforts such as one-to-one navigation, health promotion workshops, mini-grants for accessible recreation, and the Massachusetts Health and Disability Partnership. The hearing also highlighted medical education efforts like Operation House Call, which uses home visits and disability-led teaching to reduce bias and improve provider competence. No votes were taken and no formal actions were announced.

Transcript Highlights:

• I would say that you saw it in our presentation with the MassHealth budget.
• I'm the Undersecretary for MassHealth.
• I'm the Undersecretary for MassHealth.
• Of MassHealth, so I know just how important this program is.
• For MassHealth dental. Yes, I heard that discussion. So were you consulted?

Keywords: 995, all

Summary: The Joint Committee on Ways and Means held a Health and Human Services budget hearing in Clinton, with opening remarks from Chairs Meg Kilcoyne and Robin Kennedy, local officials, and many House and Senate members introducing themselves. The hearing focused on Governor Healey’s FY27 EOHHS and MassHealth budgets, with repeated themes of rising health care costs, federal funding uncertainty, workforce shortages, and access to care in underserved regions. Members also raised concerns about primary care shortages, rural and regional disparities, behavioral health access, maternal health, food insecurity, and the impact of federal policy changes on Massachusetts programs. EOHHS Secretary Kiame Mahaniah said the FY27 EOHHS budget totals $33.7 billion, reflecting mostly non-discretionary growth from health care costs, labor costs, caseload increases, and provider rate pressures. He highlighted targeted investments in foster care, family resource centers, maternal health, youth services, nutrition programs, immigrant legal services, and human service workforce rates, while warning that federal actions could strip roughly $3.5 billion annually from the state’s health care funding. In response to questions, he defended the administration’s cooperation with federal audits and program integrity efforts, discussed the primary care crisis, and said the state is trying to preserve core services while preparing for a more difficult FY28 budget cycle. MassHealth Undersecretary Mike Levine then described two major FY27 challenges: double-digit cost growth and the expected effects of the federal One Big Beautiful Bill Act. He said MassHealth’s proposed $22.7 billion gross budget includes a 7.5% increase and relies on a moratorium on new expansions plus targeted reductions, including a $1,000 annual adult dental cap, ending GLP-1 coverage for weight loss only, reducing care management to peer-state levels, and work groups to slow growth in PCA, adult foster care, and adult day health spending. Members questioned the impact on Boston Health Care for the Homeless, preventive care, and regional access; Levine said the changes are meant to preserve sustainability, that children and certain disabled populations remain protected, and that the administration will continue working with providers, advocates, and the Legislature on implementation and longer-term reforms.

Transcript Highlights:

• I'm proud to have the support of the MassHealth and Hospital Association on this legislation.
• So both MassHealth and commercial carriers cover the crisis services.
• bundle and at a rate no less than paid by MassHealth.
• That saved thousands of dollars for MassHealth.
• Currently, MassHealth covers and pays for preventive behavioral health services.

Keywords: 995, all

Summary: The committee held a hearing on a large group of behavioral health and insurance-related bills. Topics included expanding access to mental health services by allowing physician assistants to authorize Section 12 emergency holds and be recognized as licensed mental health professionals (H. 1131/S. 773); improving coverage for community behavioral health centers so commercial insurance matches MassHealth’s bundled outpatient and crisis services (H. 1276/S. 703); eliminating cost sharing for certain behavioral health services (S. 718); extending detox and clinical stabilization coverage from 14 to 30 days and adding transitional support services (H. 1319/S. 772); requiring coverage for dual-diagnosis treatment in psychiatric facilities (H. 1277/S. 771); and preserving access to treatment for serious mental illness through coverage of coordinated specialty care and assertive community treatment (H. 1135/S. 709). The committee also heard bills on preventive behavioral health services for children (H. 1228/S. 802) and post-pregnancy mental health care, including postpartum depression and pregnancy loss-related care (H. 1314/S. 823).

Transcript Highlights:

• I would say that you saw it in our presentation with the MassHealth budget.
• I'm the Undersecretary for MassHealth.
• And I'll just name, in third grade, I had an abscess while I was a MassHealth recipient.
• While MassHealth, you know, we also purchase drugs directly for many of our members.
• There was a discussion around the $1,000 limit and what we're doing for MassHealth dental.

Summary: The hearing was a Joint Committee on Ways and Means budget session on health and human services, held in Clinton and opened with remarks from the House and Senate co-chairs, local officials, and committee members. The chairs emphasized the importance of hearing directly from agencies about the Commonwealth’s health care and human services budget needs, thanked Clinton for hosting, and introduced the day’s panels, beginning with the Executive Office of Health and Human Services (EOHHS) and then MassHealth. Secretary Kiame Mahania presented Governor Healey’s FY27 EOHHS budget, describing a $33.7 billion request driven largely by non-discretionary cost growth, caseload increases, and federal uncertainty. He highlighted targeted investments in foster parent reimbursement, family resource centers, maternal health, food assistance, immigrant legal services, and workforce rates, while warning that federal cuts and the Trump administration’s One Big Beautiful Bill Act could strip billions from state health funding. Members questioned him about primary care shortages, federal program integrity audits, ConnectorCare, regional health disparities, and the proposed cap on adult dental coverage; he defended the cap as a difficult but necessary cost-control measure and said the administration would continue cooperating with federal partners. Undersecretary Michael Levine then testified for MassHealth, saying the agency faces two major challenges: rapid cost growth and looming federal changes. He outlined a $22.7 billion gross MassHealth budget and proposed actions including a moratorium on new expansions, capping adult dental benefits at $1,000, ending GLP-1 coverage for weight loss only, reducing care management spending to peer-state levels, and convening work groups to slow growth in personal care attendant, adult foster care, and adult day health programs. He also warned that federal policy changes could cause about 300,000 residents to lose coverage by 2030 and reduce federal revenue by about $3.5 billion, and said MassHealth would use outreach and systems changes to help eligible members stay covered. Members raised concerns about the impact of these cuts on homeless care, preventive services, dental access, GLP-1s, and regional hospital and specialist shortages, while Levine argued the proposals were aimed at preserving core coverage and sustainability.

Transcript Highlights:

• This would, as I said, provide payment through MassHealth for these people.
• This would, as I said, provide payment through MassHealth for these people.
• The 2020 law did not require MassHealth day habilitation providers to use the registry, so we have a
• the protections of Nikki's Law to those in MassHealth day habilitation and supervising PCA programs.
• , or authorized MassHealth, to set up a system for dealing with people who are incapacitated.

Keywords: 995, all

Summary: The Joint Committee on Children, Families and Persons with Disabilities held a hearing on a broad slate of disability-related bills. Topics included creating a permanent Acquired Brain Injury Advisory Board (H. 231/S. 134), establishing a system for compensating guardians who serve incapacitated, unbefriended individuals through MassHealth (H. 253/S. 154), expanding Nikki’s Law to require MassHealth day habilitation programs to use the abuse registry (S. 165 and related bills), modernizing and streamlining the Disabled Persons Protection Commission’s statute and procedures (H. 243/S. 139), updating the definition of developmental disability to align more closely with federal law and include people such as those with fetal alcohol spectrum disorder (H. 276/S. 150), removing outdated and offensive terminology from the General Laws (H. 232/S. 137), and an autism education reform bill (H. 286). Several bills had no sign-ups, and the committee also noted related measures on cueing and prompting in PCA programs (H. 277/S. 157).

Transcript Highlights:

• There are a number of tiers in MassHealth, so I don't only have MassHealth.
• MassHealth is really abysmally low. We have high deductibles.
• MassHealth has demonstrated their value.
• Medicaid, MassHealth.
• So this study by RTI, it actually wasn't specific to MassHealth.

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket focused on primary care, workforce development, and medical debt. Chairs Cindy Friedman and John Lawn outlined hearing procedures and noted that testimony would be taken on 17 matters. The committee first heard testimony on bills to establish a community health center nurse practitioner residency program and to strengthen mental health centers. Senator Keenan, Rep. Keefe, and health center leaders described the Worcester nurse practitioner residency as a successful pipeline and retention strategy, citing workforce shortages, training needs in community health centers, and the cost of the program. Rep. O’Day also supported the mental health centers bill, saying it would raise payment rates, improve reimbursement for behavioral health services, and help clinics retain staff and expand access. The committee then took testimony on bills to address medical debt through hospital financial assistance reform. The Attorney General’s Office, Health Care for All, Health Law Advocates, the Leukemia and Lymphoma Society, and individual patients supported the measure, arguing that hospital financial assistance policies are inconsistent, hard to find, and difficult to navigate. Witnesses said the bill would standardize eligibility criteria, create a uniform application, improve notice requirements, and expand access to discounted care up to 400% of the federal poverty level. Several personal stories described medical bills being sent to collections, confusion over insurance billing, and the burden of debt on low-income and chronically ill patients. Committee members asked about hospital concerns, the role of the health safety net, and whether the bill addressed root causes of medical debt; testimony emphasized that the proposal was meant to improve transparency and access rather than replace broader insurance reforms. The hearing also focused heavily on “Primary Care for You” legislation, H. 1370 and S. 867, which would increase primary care investment and create a new payment model. Rep. Haggerty, physicians, a patient, community health center leaders, and the Massachusetts League of Community Health Centers described a primary care crisis marked by low reimbursement, staffing shortages, long waits, burnout, and difficulty recruiting clinicians. Supporters said the bills would shift spending toward preventive, team-based care, improve access and equity, and reduce long-term costs. The Massachusetts Association of Health Plans said it was directionally supportive of increased primary care investment but warned that any new spending must stay within the cost growth benchmark and preserve existing contracting structures. The hearing ended with additional testimony on a community health center workforce and loan repayment grant bill from Rep. Stanley, and with further discussion from Dr. Alan Garo about the need for payment reform in primary care.

Transcript Highlights:

• Next up, we have representatives from MassHealth.
• MassHealth covers both the state's Medicaid and CHIP program.
• For 12 years, I have been so impressed with everybody who works at MassHealth.
• It means that just on the ground MassHealth patients are getting access to better care.
• There were 1.75 million people on MassHealth. There were 1.75 million people on MassHealth.

Keywords: 995, all

Summary: The Joint Committee on Public Health held an introductory informational hearing for the new session, with Chairs Marjorie Decker and Senator Michael Driscoll outlining the committee’s scope and emphasizing the impact of the federal landscape on Massachusetts public health. They noted the hearing would focus on testimony from agencies and advocates, with short testimony limits due to the hybrid format. No votes were taken; the meeting was for briefing and discussion of priorities. Commissioner Robbie Goldstein of the Department of Public Health described the department’s budget and federal funding, warning that recent CDC grant terminations could cut nearly $100 million and affect lab testing, surveillance, vaccines, and community engagement. He highlighted DPH priorities including racial equity, maternal health, substance use and child welfare coordination, emergency preparedness, data transparency, and public hospital quality. MassHealth Assistant Secretary Michael Levine discussed MassHealth’s role covering about 2 million residents and its priorities in health equity, behavioral health, primary care, member independence, and customer service, while noting the agency relies heavily on federal Medicaid dollars and would face major strain from federal cuts. Several advocacy and provider groups focused on reproductive health and maternal health. Planned Parenthood warned of threats to Title X, 340B savings, and other federal funding, and supported a bill to eliminate parental consent and judicial bypass for abortion care for young people. Reproductive Equity Now urged stronger shield-law protections and changes to Massachusetts’ later-abortion framework. Dr. Indyamaka Anugaka called for full implementation of the maternal health law, better reimbursement for doulas and midwives, stronger data collection, and support for full-spectrum pregnancy care coverage. The Health Policy Commission said new maternal health and primary care task forces would begin work soon. Mental health and health system access were also major themes. The Mass Medical Society urged action on vaccine hesitancy, removal of non-medical school vaccine exemptions, and primary care reform. The Massachusetts Association for Mental Health and the Children’s Mental Health Campaign opposed proposed cuts to DMH and substance use services, called for more school-based supports, and raised concerns about inpatient capacity, including a unit serving LGBTQ youth. The Massachusetts Nurses Association and 1199 SEIU warned that staffing shortages, low wages, workplace violence, hospital closures, and possible Medicaid cuts threaten patient care and the health care workforce. The Betsy Lehman Center also urged investment in automated patient-safety monitoring to reduce harm and costs.

Transcript Highlights:

• I would say that you saw it in our presentation with the MassHealth budget.
• He said that in Mattapan, 80% of his clients are on MassHealth. That's who he's helping.
• I'm the Undersecretary for MassHealth.
• And I'll just name, in third grade, I had an abscess while I was a MassHealth recipient.
• While MassHealth, you know, we also purchase drugs directly for many of our members.

Keywords: 1212, all

Transcript Highlights:

• I am here to explain why you must address the 1989 MassHealth asset limit for seniors like me.
• Thank you. ...the 1989 MassHealth asset limit for MassHealth and allow seniors like me to stay in the
• Sarah and others spoke about the MassHealth asset limit. Again, $2,000 since 1989.
• And the change in the cost to go from QMB to full MassHealth is minimal.
• So this would come from the state, through MassHealth, I would imagine, the increase?

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing focused largely on senior long-term care issues, family caregiving, post-acute care access, and direct care workforce pay. Testimony strongly supported bills to raise the personal needs allowance for nursing home and rest home residents (including H. 1411, S. 482, and related bills), with speakers from Mass Senior Action, Dignity Alliance, nursing home residents, providers, and former state officials arguing that the current $72.80 monthly allowance has been unchanged since 2008 and is inadequate for basic items like clothing, toiletries, haircuts, and transportation. Witnesses also backed bills to increase MassHealth asset and income limits for seniors and to stop counting life insurance as cash, describing the current rules as outdated and harmful to low-income elders. The committee also heard testimony on bills allowing family members, including spouses and guardians, to be paid caregivers (H. 1394/S. 886), with supporters saying this would help families keep loved ones at home and reduce reliance on costly institutional care. Another set of bills (H. 1412/S. 903) drew support from a physician who said clearer MassHealth communication and improved post-acute care determination processes would help reduce delays and backlogs for patients awaiting skilled nursing, rehabilitation, or other post-acute placement. Several speakers emphasized that better home- and community-based care can prevent hospital readmissions and support independence. A major portion of the hearing focused on S. 877, which would establish an enhanced care worker minimum wage of $25 per hour, indexed to inflation, for certain home care and human services workers. Union representatives and direct care workers from SEIU Local 509, 1199 SEIU, and the AFL-CIO described severe staffing shortages, burnout, low wages, and high turnover across home care, mental health, disability services, and crisis response. They argued that higher pay is necessary to recruit and retain workers and to stabilize services for vulnerable residents. Committee members asked about costs, comparisons with other states, and whether non-wage incentives could help, but witnesses repeatedly said wages were the central issue. The hearing concluded after all registered testimony was heard, with the committee noting it would continue accepting written testimony and then adjourning.

Transcript Highlights:

• It's the fact that our MassHealth enrollees are getting older, they're getting sicker, they have higher
• It's not the number of enrollees, it's the cost per enrollee in MassHealth. Thank you, Mr.
• One is MassHealth, by far the largest line item in the state budget. One is MassHealth.
• We keep a really close eye on MassHealth. The other agency I want to talk about is DTA.
• This budget invests to preserve coverage for all in Massachusetts and to begin fortifying MassHealth

Summary: The Senate first adopted two resolutions commending the Plimpton Historical Society for Deborah Sampson Day and Megan’s Light for recognizing May 2026 as Cystic Fibrosis Awareness Month. It also suspended Joint Rule 12 on several House petitions, referred those matters to committees, and later took up final passage of two local bills: one authorizing Dartmouth to grant an additional off-premises liquor license and another relative to the charter of Westwood. Both bills were passed to be enacted and sent to the Governor. The main business of the session was the opening debate on the Senate Ways and Means FY27 budget, which was described as a balanced $63.3 billion proposal. The chair and supporters highlighted major investments in unrestricted local aid, Chapter 70 education funding, regional school transportation, rural aid, community college affordability, food security, housing, and health and human services. They also emphasized that the budget was built on the consensus revenue estimate, included no new taxes or tax cuts, did not use the rainy day fund, and relied in part on federal funds and Fair Share revenue. In extended questioning, the minority leader pressed for details on the budget’s assumptions and cost drivers, including federal participation, Fair Share revenue, debt service, MassHealth caseload and spending, pension and OPEB liabilities, settlement reserves, collective bargaining funding, and controls against waste, fraud, and abuse. The chair responded that federal funds account for about 22% of budgeted revenues, Fair Share revenue is estimated at about $2.7 billion, debt service is about $2.67 billion, MassHealth and related health and human services total about $36.4 billion, pension funding is $5.1 billion, and OPEB receives a $150 million payment. Members also discussed the C-3 child care program, DTA program integrity, and housing permitting reforms, with several senators speaking in support of the budget’s priorities and urging further debate and amendments before final passage.