Opponents see reform as risky, cite state’s near-universal coverage
STATE HOUSE, BOSTON, JUNE 18, 2025…..With hundreds of thousands of Bay Staters at risk of losing health insurance coverage under congressional plans to cut Medicaid funding and adjust eligibility criteria, insurance reform advocates turned out in droves on Beacon Hill Wednesday to promote legislation to establish a single-payer system in Massachusetts.
The perennial “Medicare for All” bills, which would guarantee access to health care services for Massachusetts residents, have never advanced out of committee. Supporters this session are stressing new urgency tied to rising health care costs, the Steward Health Care crisis and a spate of hospital closures — with that backdrop exacerbated by looming federal cuts.
Refiled proposals from Reps. Lindsay Sabadosa and Margaret Scarsdale and Sen. Jamie Eldridge (H 1405 / S 860) would eliminate deductibles, premiums and copays. The model could slash health care spending by 30%, while also eliminating medical debt and medical bankruptcy, according to Eldridge’s office. It would be funded by imposing new taxes on employers, workers and residents.
“Why do we need Medicare for All? Because it would have prevented the Steward crisis that is continuing in our state,” Kimberley Connors, executive director of the Massachusetts Campaign for Single Payer Health Care (Mass-Care), said at a Health Care Financing Committee hearing.
Connors ticked off Holy Family Hospital’s recent plans to shutter some services at the Haverhill campus and operate a satellite emergency facility, the closures of Carney Hospital and Nashoba Valley Medical Center last year, and the abandoned under-construction Norwood Hospital. Connors also pointed to what she described as a preventable situation at the Group Insurance Commission, which was at risk of running out of money to pay claims for state employees before the Legislature had to deliver a $240 million injection last month.
Dr. Mardge Cohen, an internal medicine physician, said her five decades of experience in Chicago and Boston have given her a “front row seat to the impact of a cruel and dysfunctional health care system.” Cohen testified on behalf of Physicians for a National Health Program, which she said represents more than 20,000 physicians who support a universal single-payer system.
“Why is the current system so costly? There is the waste from all the diverted money for corporate headquarters, profits and dividends, waste from all the lack of coordination and discontinuities, re-enrolling, advertising, annual re-enrollments, disenrollments, eligibility evaluations and an army of unnecessary policies and gatekeepers,” Cohen said. “All this money could be used to meet health care needs.”
Aaron Singer, a Walpole resident, recalled how he broke his ankle in 2014 in South Korea, which has a single-payer system. The country also has a “booming” medical tourism industry, he said.
“That’s right, medical tourism — comprehensive checkups, cancer treatments, plastic surgery, you name it. There’s a good chance it’s cheaper to fly there and get treatment instead of getting it done here in the states,” Singer said. “The X-ray for my broken ankle was $15. I felt like I had been lied to my whole life.”
Eldridge at the hearing compared “Medicare for All” to the state’s public education system, in which he said all children have a right to education that’s funded through taxes.
“As federal funds potentially are jeopardized, the existing funding structure for MassHealth — Massachusetts must explore more sustainable and equitable alternatives, and find ways to significantly reduce health care expenses,” Eldridge said. “Medicare for All can significantly accomplish both goals.”
The U.S. House-approved reconciliation bill, which is now pending before the Senate, features deep tax cuts and spending reductions. It also threatens to unravel the typical flow of millions of Medicaid dollars to states.
Under the House package, as many as 100,000 Bay Staters could lose their coverage through the Massachusetts Health Connector, and another 150,000 people could lose their MassHealth eligibility.
Sen. Cindy Friedman, co-chair of the HCF Committee, pointed out that Massachusetts has one of the lowest insured rates in the country, plus some of the “best hospitals.”
“But all of this will not insulate us from the cuts to federal health care funding, workforce and programs,” Friedman said. “Everyone in this room will feel the impact of these cuts, especially our most vulnerable residents who already face enormous challenges to getting care in our system. It is more important than ever for us to work together and ensure that every resident of the commonwealth can receive the care they need.”
The single-payer bills would impose an employer payroll tax of 7.5%, with an additional 0.5% tax levied on businesses with more than 100 employees. There would also be an employee payroll tax of 2.5%, and a 10% payroll tax on self-employed individuals. The employer and employee taxes would exempt the first $20,000 in wages and income.
While the vast majority of Massachusetts residents have insurance coverage, regulators say rising premiums and deductibles are prompting Bay Staters to forgo certain care, including preventive care that can reduce subsequent emergency visits.
Lora Pellegrini, CEO of the Massachusetts Association of Health Plans, argued the Medicare for All legislation would not solve health care affordability issues.
“Mandating a one-size-fits-all, government-run health care system would eliminate meaningful health care choices for patients and require dramatic tax increases on residents and employers across the Commonwealth,” Pellegrini said in a statement to the News Service. “It would also jeopardize the significant progress Massachusetts has made in achieving near-universal coverage and divert attention from the urgent work needed to control the actual drivers of rising health care costs, namely, unchecked provider prices and the skyrocketing cost of prescription drugs.”
Ahead of the hearing Wednesday morning, Gov. Maura Healey’s office touted that Massachusetts had scored the top ranking for overall health care performance in the Commonwealth Fund’s 2025 Scorecard. The nonprofit’s rankings are based on metrics including health care access, affordability, prevention and treatment, avoidable hospital use and costs, health outcomes, income disparity and equity.
Massachusetts performed “best” when it came to addressing childhood vaccinations, infant mortality and colorectal cancer deaths, according to the scorecard. But the state performed “worst” when it came to skilled nursing facility residents with a hospital readmission, preventable hospitalizations for residents ages 65+, and the hospital 30-day readmission rate for those ages 65+.
“Massachusetts is yet again the best state in the nation for health care,” Healey said in a statement. “We’ve made significant progress in expanding access to affordable health care, making sure people have health insurance coverage, and supporting the health and wellbeing of children and babies.”
Two weeks ago, when insurers filed steep proposed rate increases, Healey said health care costs are “simply unsustainable.”
“What is clear is that we all must do much more to lower the cost of health care in this state,” Healey had told the News Service.
