Massachusetts Gov. Maura Healey is taking aim at the state’s health care costs from several directions at once, putting more money into primary care while trying to curb surprise bills and costly gaps in the system. Healey announced the first recommendations from her Health Care Affordability Working Group on Monday at Cape Cod Hospital, outlining a plan that reaches from MassHealth payment rates to nursing recruitment and out-of-network billing. The governor’s office is presenting the package as an early move in a broader effort to make care less expensive for residents, employers and state budgets, as reported by the Boston Herald.
Primary Care Would Get A Bigger Slice Of MassHealth Spending
Healey signed an executive order directing MassHealth to increase primary care investment to 12% of total medical spending by the end of 2028. That would build on recent gains: MassHealth data shows primary care accounted for 8.4% of spending in 2024, up from 7.6% in 2023.
The administration also plans to invest in the nursing workforce through scholarships and loan forgiveness, an approach designed to make it easier for people to enter or remain in health care jobs. More primary care capacity could help patients manage chronic conditions earlier and reduce pressure on emergency departments, although the strategy is aimed at long-term system costs rather than an instant drop in next month’s premium.
State Wants Fewer Surprise Bills And More Predictable Rates
Another recommendation directs the Massachusetts insurance commissioner to work with insurers and providers on standardized rates for out-of-network services. The goal is to reduce loopholes that can leave patients facing unexpected medical bills, while the state employee health insurance system would establish fair-price standards for some services without restricting members’ choice of providers, according to the Boston Herald’s coverage.
The administration’s January launch of the working group framed the effort as a push against administrative waste, rising prices and other structural problems rather than another short-term subsidy. The Healey administration’s January announcement also included changes to prior authorization rules for many routine and essential services.
Discharge Delays Show Why System Changes Matter
Healey’s package also calls for streamlined care transitions, including a standardized discharge form and updated rules for surrogate health care proxies. That may sound like paperwork, but Massachusetts hospitals have been dealing with a major bottleneck: a state task force report found that more than 2,000 people were still in acute-care settings each day despite being medically ready for discharge, with some waiting more than 30 days.
The working group will continue through the end of 2026 and is developing additional recommendations on health data sharing, commonly ordered but low-value care and prescription drug costs. It is also examining how the state can use its purchasing power and improve coordination across hospitals, insurers, providers and government agencies.
The timing is politically and financially loaded. Healey and her allies have warned that federal Medicaid cuts could make the affordability challenge harder, meaning the governor’s plan is being asked to lower costs while the funding environment around public health coverage grows more uncertain.
