Authorizes Arlington to use ranked-choice voting for specified local offices, pending voter approval; uses round-by-round tallies and publishes results to boost transparency.

Requires insurers to allow medication sync with pro-rated copays and full dispensing fees; cannot deny partial fills for syncing; aims to boost adherence and lower costs.

Requires a separate prescription drug out-of-pocket limit in MA health plans, capped at the HDHP minimum annual deductible, protecting patients from high drug costs starting 2026.

Moves to curb PBMs in Massachusetts to expand pharmacy access by ensuring payment parity, banning steering and retroactive discounts, and mandating MAC transparency and updates.