Mass. health bills, one prompted by Steward crisis, may yet pass

Two House committee chairs agreed that at least some of the health care-related bills still have a good shot of becoming law.

“We left work unfinished, and we’re not done,” said state Representative Marjorie Decker, a Cambridge Democrat and House chair of the Joint Committee on Public Health.

Now a swath of Massachusetts residents whose lives could be profoundly affected by the bills wait in limbo.

Five health-related bills were on the cusp of passage when the Legislature’s session ended early Thursday. One would license midwives and ensure they are covered by MassHealth. Another would provide support for people struggling with substance abuse and end a requirement that health care providers and some other professionals notify the state’s child protection agency when a baby is born exposed to drugs. Another two bills increase state oversight of the nursing home and pharmaceutical industries. Hospitals, too, could have received more scrutiny with the passage of the private equity bill.

“I’m extremely disappointed,” said Paul Lanzikos, a coordinator for the disability advocacy group Dignity Alliance Massachusetts who lobbied for a bill to improve oversight in the nursing and long-term care industry. ”We’re getting reports from literally all around the state of operational failures, staff not getting paid properly, vendors not getting paid.”

The health care bills passed with broad support in both houses. That gave legislators confidence that they could reconcile the House versions of the bills with their Senate counterparts over the coming months. Moving the bills out of session, though, presents its own challenge. The votes for the reconciled bills must be unanimous in both houses for the bills to pass before the informal session ends Dec. 31.

As of Wednesday, all that was needed to bring the bills to the governor’s desk were some negotiations and a last vote in the House and Senate. But that didn’t happen.

Instead, as legislators wrangled with a marathon voting session, the bills stalled out in conference committees.

“It’s unacceptable that so much didn’t get done by the end of formal session,” said state Senator Julian Cyr, a Provincetown Democrat and member of the health care finance committee.

The hospital reform bill appeared to be a priority. Among other provisions, it would increase fines for hospitals that failed to give state regulators financial data, which happened with Steward. In an interview Thursday, House Speaker Ron Mariano said, “I’m pretty confident about the health care bills.”

“I’d rather have something that makes sense and goes in operation,” he said. “It’s my priority.”

Steve Walsh, chief executive of the Massachusetts Health and Hospital Association, preferred legislators take their time considering a complex, 115-page health care reform bill rather than cram in a vote before the end of the session.

“To their credit, they chose no action by midnight on July 31, in favor of more discussion and review to make sure that when they acted it was the right direction,” he said.

Alan Sager, a professor of health law and policy at Boston University, said health care legislation often languishes because of legislators’ unfamiliarity with the complexities of health policy and because of the powerful influence of money in the massive industry.

“The bedrock of the difficulty is [that] so many people in state government, in the Legislature and in the administration, don’t want to deal with health care,” he said.

The bills reforming hospital and nursing home oversight, as well as another stalled bill that sought to reduce long delays in completing wheelchair repairs, would all have addressed private equity and for-profit involvement in the health care industry. Rather than tackle regulating a complicated and profitable industry, Sager said, legislators and officials too often fall back on the excuse that the free market should be allowed to function.

State Senator Cindy Friedman, the Senate chair of the health care finance committee, disagreed that legislators dodge health issues. Rather, she said, the Legislature ran out of time to address them properly.

A few days ago, Katherine Rushfirth, policy director of the Neighborhood Birth Center, had hopes that her long-planned birth center in Boston’s Nubian Square could finally become a reality. A birth center in a Black neighborhood would give pregnant parents an alternative to delivery in hospital and could address dangerous trends in maternal morbidity that disproportionately threaten Black mothers. With the passage of the maternal health bill, improved MassHealth reimbursement rates and insurance coverage for midwives would make the plan feasible and would make midwives affordable for more parents. If the bill doesn’t pass, she said, she will need millions in philanthropic support to open the birth center.

“We are disappointed and frustrated,” she said. “We’re going to be at a decade trying to get a neighborhood birth center open.”

Samantha Gross of the Globe staff contributed to this report.

Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin.

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