House passes bill to boost primary care funding as negotiations continue with Senate
A House-passed bill would boost primary care spending gradually over a decade, but the Senate's faster timeline remains in dispute.
NORTHAMPTON — The Massachusetts House has passed a sprawling healthcare bill that would gradually increase primary care spending to 15 percent of all healthcare dollars by 2036, offering a potential turning point for doctors struggling with shortages and burnout in the field.
Dr. Kate Atkinson, who operates Atkinson Family Practice with offices in Northampton and Amherst, has watched colleagues leave primary care for direct-pay models or other specialties as insurance paperwork and low reimbursement rates mount. "There are no primary care physicians accepting patients in our area," she said in an interview. The House passed the bill 158-0 on July 30, and it now heads to conference negotiations with the Senate version.
Currently just 6.6 percent of commercial healthcare spending goes to primary care, according to the Center for Health Information and Analysis. The House bill would increase that spending to 9 percent by 2030, 12 percent by 2033, and 15 percent by 2036. The Senate wants to reach the 15 percent target by 2030, a faster timeline that House Speaker Ron Mariano said would be harder for insurance companies and hospital networks to manage.
Rep. Greg Schwartz, a primary care physician, said the House approach "gives our provider networks and insurance payers enough time to adjust their contracts to achieve these goals smoothly." The House set an aggregate spending goal rather than requiring individual healthcare entities to meet a target, and it includes allowances for safety-net and teaching hospitals. Mariano noted the bill permits "non-financial" contributions, such as hiring extra nursing staff to extend clinic hours.
The legislation exempts smaller physician groups with patient panels of 15,000 or fewer, or those earning less than $25 million in annual net patient revenue. It also requires commercial insurers to reimburse community health centers at MassHealth rates, mandates coverage of mobile integrated health services, and includes provisions on artificial intelligence use in insurance reviews, pharmacy benefit manager oversight, and drug rebates.
Atkinson, a doctor in her 60s, said she is unlikely to practice long enough to see the full benefits of the funding increases, but she supports the effort. She called on residents to push for the bill's passage. The legislation would reduce prior authorization paperwork that "eats up hours of every PCP's week," fund healthcare management work that currently goes unpaid, and help recruit physicians to the field, reducing burnout and early retirements. For patients, the result would be shorter wait times and greater availability of appointments.