Bill
S 849
The bill requires state agencies to benchmark costs of a universal single-payer system, compare them to 2025–2027 actual spending, and, if savings appear, enable a formal implement
Status (as provided)
- Introduced: January 8, 2025 (Senate Docket No. 143 / Senate No. 849)
- First reading / referral and committee actions noted through March–June 2025 (see Procedural History below)
- Note: metadata supplied with the request contains conflicting items (a different bill title, sponsors from other jurisdictions). This summary is based on the bill text filed as Senate No. 849 (Julian Cyr), which establishes a process to evaluate and potentially implement a Massachusetts single‑payer health care system.
Purpose
- To require state analytic agencies to develop a benchmark estimate of the cost of a single‑payer health care system and to compare that benchmark to actual Massachusetts health care spending for 2025–2027. If the benchmark shows cost savings for those years, the Health Policy Commission (HPC) must produce a single‑payer implementation plan.
Key provisions
- Definitions: establishes "single payer benchmark" (estimated total costs to provide health care to all residents under a single‑payer system in a given year) and defines "single payer health care" (publicly financed, universal coverage through a unified public plan).
- Methodology: directs the Center for Health Information and Analysis (CHIA) to recommend a methodology to develop the single payer benchmark. CHIA must consider multiple actuarial values, cost‑sharing levels, and provider reimbursement levels and review single‑payer systems in other jurisdictions.
- Comparative reporting: CHIA, together with the Health Policy Commission and the Division of Insurance, must file an annual report comparing actual Commonwealth health care expenditures for 2025, 2026 and 2027 with the corresponding single payer benchmarks for those years. The first report is due by July 1, 2027.
- Implementation trigger and plan: if the report finds the single‑payer benchmark “outperformed” (i.e., would have been less costly than) actual total expenditures for all three years (2025–2027), the HPC must submit a proposed single‑payer implementation plan to the Legislature and relevant committees within one year of the report. The plan may include proposed legislation and must be informed by at least three public hearings and stakeholder input statewide.
Who would be affected
- State agencies: CHIA, Health Policy Commission, Division of Insurance (responsible for analysis and reporting).
- Massachusetts residents: potential eventual beneficiaries of a single‑payer plan if implemented.
- Health care providers, insurers, employers, and taxpayers: affected indirectly through any proposed policy changes and fiscal implications identified in the benchmark and implementation plan.
Timeline and procedural highlights
- CHIA/HPC report due: by July 1, 2027 (comparing 2025–2027).
- If benchmark shows savings for all three years: HPC must deliver an implementation plan within one year of that report.
- The bill text was filed Jan 8, 2025. Legislative action entries provided show referrals and scheduling of hearings through mid‑2025; those entries contain some duplications and possible cross‑jurisdictional inconsistencies in sponsors/committees.
Potential impact (summary)
- The bill does not itself create a single‑payer system or specify funding mechanisms; rather it mandates a structured, evidence‑based process to estimate single‑payer costs and to compare them with actual spending. If the benchmark indicates net savings, the bill creates a clear pathway for the HPC to propose detailed implementation legislation, including public engagement. Financial impacts would depend on the benchmark methodology, assumptions (actuarial values, cost‑sharing, provider payment levels), and any legislative choices in a subsequent implementation plan.
Compiled from official sources — confirm details with the bill’s official record.
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