House-Senate feud threatens health care agenda

Boston Statehouse

Health Care Financing Committee Co-Chair Sen. Cindy Friedman and Vice Chair Rep. Dan Cullinane at a hearing in June 2019. (Photos: Sam Doran/SHNS/File)

BOSTON (SHNS) – With veto-proof supermajorities in both the House and Senate, Massachusetts Democrats are almost guaranteed success in crafting new laws when they have agreement within their ranks, particularly when they are responding to pressing circumstances such as a global pandemic.

But intraparty sniping on the committee in charge of health care bills has devolved into an all-out brawl over legislative procedures and negotiation faith, imperiling the fate of hundreds of bills in the process while raising questions about whether Democrats can put aside differences to advances major priorities in July.

Only five weeks remain until the July 31 deadline after which lawmakers will not be able to take recorded roll call votes. After they could not get an agreement across the finish line during the last two-year session, legislators risk ending this time around without another batch of failure on several major health care bills.

The tension stems from a dispute between leaders of the Joint Committee on Health Care Financing that has been simmering for months. Senate Chair Cindy Friedman and House Acting Chair Dan Cullinane brought the fractures into full public view over the past week as a key deadline approached and then passed.

Over that span, Friedman publicly questioned whether the House wants to accomplish health care reform this session and how it defines its role as a legislative body, while Cullinane accused Friedman of violating legislative rules and circumventing the traditional committee process to pursue Senate goals.

In an unusual step, the Senate on Thursday rejected a House-approved order extending the review deadline on 341 bills before Health Care Financing until Dec. 31, five months after the end of formal lawmaking sessions.

That automatically placed a negative recommendation on every one of the bills, and the Senate then plucked out 26 of those bills and sent them to the Ways and Means Committee, keeping them alive in the short term.

At Thursday’s session, Friedman called the extension at this stage in the session “nonsense.”

“Otherwise, they would have just sat there in Health Care Financing until Dec. 31, which means we couldn’t do anything with them if they came out of committee,” she told the News Service on Friday. “We don’t even know if we’re going past July. We have no idea. So it just didn’t make any sense to us to do that.”

Noting the planned July 31 end of formal sessions, Friedman said in the Senate: “Our formals will end soon. We’re in the middle of a pandemic. Our health care system has been turned upside down. And our residents are depending on us to lead and to do everything we can to provide accessible and quality care. We can’t wait. They can’t wait. And so, it’s time to move the bills along.”

Cullinane, who said the long extension would not have precluded action by the Legislature, has complained alongside other House leaders that the Senate’s approach “obstructed” the committee process.

When he sought the extension last week, he wrote to the House Clerk to explain the scope of the request and to outline his concerns that the Senate showed “disregard” for the committee’s role.

Cullinane said Friedman declined requests to open a poll on other bills unless she got a guarantee that Senate priorities would be sent to the Senate for a vote.

“Quite frankly, what the Senate chair prevented from happening was she prevented the membership that’s supposed to vet and vote on these pieces of legislation — she held hostage those members from vetting and voting,” Cullinane said in a Friday interview. “She did that to sidestep the committee process to do what she did on the floor this week, which is picking out the bills she wanted to go forward at the expense of the joint rules and the committee process.”

Friedman confirmed that she would not agree to a poll of Health Care Financing members last week on a range of legislation because Cullinane “wouldn’t agree once we opened the poll where the bills would go.”

She said she had an agreement in place with Cullinane’s predecessor, former Rep. Jennifer Benson, that “Senate bills would come back to the Senate and House bills will go back to the House.”

Benson resigned in January to become president of the Alliance for Business Leadership, and Cullinane, who had been the committee’s vice chair, stepped up as acting chair.

Asked about Friedman’s description of the agreement, Cullinane said the House’s committee staff did not change after Benson’s departure and that, “according to them, that is flatly untrue.”

“Giving the same ultimatum five times is not the same as sending five proposals to the House. They’ve engaged in this ultimatum of ‘we want all of the Senate bills and that’s the way it’s going to be, or it’s no poll,'” Cullinane said. “Last week, we saw the totality of the legislation die by the vote of the Senate, and they own that 100 percent.”

Their dispute reveals a tension central to much of the Legislature’s committee process: because the House is larger, it is able to exercise stronger control of every joint committee with more seats on each panel than the Senate.

As a result, bills under review in joint committees cannot head to a branch for a full vote if its House members do not sign off — meaning if the Senate wants to pass a measure, it either needs to have House lawmakers agree to advance the bill to the Senate, where senators can move bills to the floor after redrafts by the Senate Ways and Means Committee, or run the entire process through Ways and Means.

Major pieces of health care legislation in Massachusetts face an uncertain future amid the infighting, two years after private negotiations collapsed at the end of session.

Both branches agreed last year on a proposal aimed at increasing access to health care for vulnerable children, but Senate-approved bills aimed at achieving parity between physical and mental health care and at reining in prescription drug prices remain untouched in the House.

The Senate’s most recent sweeping bill approved Thursday — one that went through Ways and Means — aims to keep insurance companies covering telemedicine, allows nurse practitioners, nurse anesthetists and psychiatric nurse mental health specialists to practice independently, and calls for a default out-of-network rate to protect patients from surprise bills.

Pointing to those provisions, Friedman argued that the legislative process should not outweigh legislative results, particularly given the current public health crisis.

“There’s lots of time people do things and I’m not all that thrilled with the way they do them, but if the subject matter is important, I’ve got to get over that,” Friedman said. “That’s how I look at it, but I can’t tell you how the House is looking at it.”

It remains unclear what exactly the House’s approach will be in response. In a statement, a spokesperson for House Speaker Robert DeLeo said the COVID-19 pandemic has shown “the real benefits of telemedicine yet also unanswered questions.”

“The House intends to pursue a limited healthcare bill that takes into account the fact that the healthcare marketplace is still in the midst of unprecedented, destabilizing uncertainty,” DeLeo’s office said. “The House believes the Commonwealth should show a commitment to some form of telemedicine prior to asking our incredible hospitals to invest further, particularly as they are focused on caring for COVID patients.”

Both Friedman and Cullinane said they were ready and willing to work with the other side, even as both continued their ongoing criticism.

“We had hoped to have a willing partner on the Senate side to engage in the full legislation before the Joint Committee on Health Care Financing, and we didn’t,” Cullinane said.

“We will talk to anybody at any time, anybody who’s really willing to engage in solving these problems,” Friedman said, nearly echoing Cullinane. “We’re ready. But we need an eager and willing partner, and that’s what we’re looking for.”

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