Senate advances health care overhaul, single-payer study

The Massachusetts Senate approved a wide-ranging health care reform bill late Thursday that includes a call for the state to study how much a single-payer insurance system would cost.

Final passage came on a 33-6 vote shortly before midnight after two days of debate and dozens of amendments. All six Republicans in the Democratic-controlled chamber voted against the final bill, which faces an uncertain road ahead.

The legislation seeks to lessen the wide price disparities between large hospitals, like those in Boston, and smaller community hospitals around the state. The smaller providers have long complained that they are paid significantly less for the same or similar services offered to patients as the bigger facilities.

Following objections from Partners HealthCare, the state's largest provider, the Senate modified a provision that originally sought to penalize the state's three biggest hospitals if they failed to hit benchmarks for controlling spending.

The bill also seeks to address rising drug costs by requiring pharmaceutical companies to submit pricing data to the state's Center for Health Information and Analysis. And it would require hospitals to formulate strategies for reducing the number of patients who are readmitted for care within 30 days of their original discharge.

The Senate voted 35-3 to adopt an amendment proposed by Sen. Julian Cyr, a freshman Democrat from Truro, calling for a study of what it would cost Massachusetts to implement a government single-payer health care system, along the lines of what Vermont U.S. Sen. Bernie Sanders advocated for on the federal level during his 2016 presidential campaign.

If the annual cost estimate was lower than the overall cost of the current market-based system, the state would then be directed to begin laying groundwork for a single-payer plan.

Lora Pellegrini, president of the Massachusetts Association of Health Plans — a group that represents insurers — praised elements of the Senate bill in a statement Friday but warned that discussions about single-payer "distract from efforts to focus on cost control and ignore the fact that Massachusetts has almost 100 percent universal coverage today."

Another of the bill's provisions allows licensing of dental therapists, who wouldn't be dentists but could perform some common procedures such as fillings and tooth extractions in community settings.

The bill now moves to the House, where Democratic leaders have indicated plans to write their own reform bill, and one that may be narrower in scope than the Senate.

Republican Gov. Charlie Baker, who supports some of the Senate's initiatives, has been critical of senators for not pursuing many of the cost-saving measures he proposed for MassHealth, the state's Medicaid system.

"My big concern about the Senate health care bill is it doesn't save the state any money," Baker told reporters Thursday.

Senate Ways and Means Chairman Karen Spilka has estimated the Senate bill would trim annual MassHealth spending by $114 million, while reducing overall health care costs from $475 million to $525 million by 2020.

Health Care for All, a group that advocates for affordable universal care, praised the Senate approach.

"This comprehensive bill takes bold action to reduce health costs, protect consumers in health insurance plans, advance oral health, and improve the quality of our care," said Amy Rosenthal, the group's executive director, in a statement prior to final passage.

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Associated Press writer Steve LeBlanc contributed to this report.