Spilka hints at future Senate policy priorities

By Alison Kuznitz

For the Gazette

Published: 06-19-2023 3:01 PM

BOSTON — The Senate is looking to tamp down soaring prescription drug costs, Senate President Karen Spilka said during a business breakfast Thursday where the Ashland Democrat also talked about other legislative priorities for the slow-starting two-year session.

“I hope this time — the third time — is the charm, as the saying goes,” Spilka said, referencing unsuccessful legislation in the prescription drug area in the last two sessions, during a Greater Boston Chamber of Commerce event. “And we will provide the Health Policy Commission with the most effective enforcement tools to ensure a successful cost containment across the health care system, including drug prices.”

The Senate agrees with the chamber, Spilka told its members, about strengthening oversight of pharmacy benefit managers and pharmaceutical manufacturing companies as the HPC looks to “better analyze” health care cost trends.

During a hearing earlier this month, Sen. Cindy Friedman and Rep. John Lawn, co-chairs of the Joint Committee on Health Care Financing, criticized a PBM representative who claimed the industry model isn’t responsible for rising costs. PBMs negotiate between insurers, manufacturers and pharmacies, in what Lawn characterized as an almost “mob-like approach” that allows them to extract billions of dollars from the supply chain without pursuing any innovation or research and development.

Acknowledging steep child care costs that are affecting families across all income levels, Spilka also pledged that the Senate will revise and reintroduce an early education and child care bill that she said would be “stronger” than last session’s bill.

“We can’t keep families here or best prepare our students for future success without fixing our child care problem,” Spilka said.

On both prescription drug costs and early education and child care, Senate Democrats have been unable to gain traction not because they don’t have plans, but because they have been unable to reach consensus with Democrats in the House on policies.

Spilka said the Senate is also poised to explore “mobility pricing” through a special commission proposed in the Senate’s fiscal 2024 budget, which is currently under negotiation in a House-Senate conference committee.

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The commission — stemming from a Sen. Brendan Crighton budget amendment — is “long overdue,” Spilka said, noting some attendees paid tolls as they drove to the forum, while others didn’t depending on which roads they traveled. The commission’s goal is to study the financial, travel and environmental effects of congestion pricing, as well as issues tied to public transit fares like the impact of means-tested fares on the MBTA and regional transit authorities.

The commission would need to file a report with recommendations, plus up to five scenarios for mobility pricing plans, by July 2025, according to the budget amendment.

“We charge public transportation commuters after parking and passes almost as much, if not more, to take public transportation than to drive,” Spilka said. “We need to do better. We need a pricing system that reliably collects revenues, but that also encourages those who are able to get out of their cars and into public transportation.”

The cost of public transportation shouldn’t pose a barrier to middle-income residents, Spilka said.

Massachusetts remains reliant on gas tax revenue despite the state’s aggressive push for an electric vehicle future, Spilka said. During a question-and-answer segment with chamber president Jim Roomey, Spilka said the pace of meeting climate goals — including reaching net-zero greenhouse gas emissions by 2050 — “definitely concerns me.”

Claiming “no diss” to the Baker administration, Spilka said she’s not aware of officials using $63 million from the federal government in the “last year or the year before” to install charging stations throughout the state.

“Just imagine if you have a gas car, picture the state without a gas station,” Spilka said. “Forget about going across from the east side of the state to the Berkshires — how would you even get to Worcester, or in some ways, from the Cape? We need to have charging stations all over the place to ensure that people who want an electric vehicle can buy it, can afford it.”

But Spilka did directly pin responsibility on the “prior administration” for mistakenly using $2.5 billion in federal money to pay jobless benefits rather than pulling from the state’s Unemployment Insurance Trust Fund during the COVID-19 pandemic. Federal and state dollars were put into the same bucket, Spilka said, as officials worked to quickly deliver benefits for several different programs amid changing guidelines.

“It does appear that other states have some issues, as well,” Spilka said. “Hopefully in unity, there is strength that there will be a solution that will help us and the other states as well.”

Senate Ways and Means Chairman Michael Rodrigues, in an interview after Spilka’s remarks, said he’s “not concerned” about the multi-billion-dollar error that wasn’t discovered until a third audit from an outside firm.

“It’s another issue that we’ll have to deal with, but we’ll be fine,” Rodrigues said.

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