Salem council shows support for single-payer health insurance program

SALEM — City councilors are supporting a resolution to state lawmakers for two bills that would establish Medicare for all Massachusetts residents, which proponents project would save cities like Salem millions of dollars on health insurance.

During the Salem City Council’s May 28 meeting, Ward 5 Councilor Lydia King introduced a resolution to show local support for House Bill H.1405 and Senate Bill S.860, An Act Establishing Medicare for All in Massachusetts. The bills would establish the Massachusetts Health Care Trust, funded through a payroll tax to eliminate spending on private insurance, for a single-payer, public insurance program that is projected to be less costly to Massachusetts residents than their current premiums, deductibles, and copays.

The legislation would cover all necessary preventative, medical, dental, vision, hearing, mental health, and long-term care, enable people to see their current, or any, in-state provider, provide for out-of-state emergency care, and ensure health decisions are made between patients and their health care providers, not insurance adjusters.

The resolution says approximately 200,000 Massachusetts residents, including 3% of Salem residents, lack health insurance, while many more struggle to access care due to high out-of-pocket costs despite being insured.

King’s resolution notes the city is projected to spend over $21 million on medical insurance for city and school employees and retirees in Fiscal 2027, representing an 8.2% increase over last year. Based on municipal payroll data from the state and the tax rates proposed under the Medicare bills, the city would have saved over $8 million in Fiscal 2024. King projected annual savings would increase to $11.3 million for the current fiscal year.

“The fact that this would allow people to prioritize preventative care is so important in the city of Salem,” King said. “At Salem Hospital, wait times for the Emergency Room are upwards of 12 hours today, and that is because so many people are forced to go to the hospital only when an emergency is happening, because they do not have the proper health insurance to get preventative care and prevent those emergencies.”

During public comment Thursday, Salem resident Jeremy Mele implored councilors to support the bills, which he said address a vital need for the well-being of Salem residents.

“There are few needs more pressing than the need for universal healthcare,” Mele said. “The current system leaves the uninsured and underinsured uncared for, bankrupts families, and kills. People die, including Salem residents, because they cannot afford to get the healthcare they need.”

Councilor at-Large Kyle Davis said that beyond the altruistic standpoint of providing healthcare access to community members in need, the legislation makes sense from a fiscally conservative perspective, as one of the leading contributors to the city’s expenses each year is the rising cost of health care for employees.

“The most expensive thing in our budget is people, that is skyrocketing year over year because the cost of health insurance continues to go up,” Davis said. “The fact that businesses and small businesses need to take on this cost is a huge financial challenge on top of everything else that just doesn’t exist in other developed societies. It’s because of the failure of state and federal leadership that this would be on a small business to try and insure someone.”

Ward 6 Councilor Katelyn Holappa highlighted a current loophole where, despite the constitutional right to gender-affirming care, federal laws dictate that out-of-state insurance agencies are not required to provide coverage for such treatment.

“Access to gender affirming care is a constitutional right in the Commonwealth of Massachusetts, but they cannot force an out-of-state insurance agency to do anything,” Holappa said. “If you live in the Commonwealth and you work for a company that is incorporated in a different state, and you have a constitutional right to care, they can deny you and there is nothing you can do about that. This would prevent that loophole.”

While in support of the resolution, Ward 3 Councilor Jason Sydoriak raised concerns that the bills should acknowledge counter-arguments to the program and provide a better overview of the economic impacts that could be seen if implemented. Sydoriak specifically referenced the push for single-payer healthcare in Vermont, an initiative that failed largely due to concerns that tax increases would be economically infeasible for residents.

“There is a reason why no other state has been able to accomplish this, whether it’s political will, or as you can see in Vermont, not being fiscally possible,” Sydoriak said. “I think we need to acknowledge these (counter-arguments), and then within ourselves and those who are listening, try to encourage our state leadership to make sure we land this, because this is an incredibly difficult thing to do. The benefits are there, but there is no economic impact assessment seeing actually how expensive this will be. We are creating a tax base that doesn’t exist right now.”

Ward 2 Councilor Andrew Smith cautioned that the legislation is not a “silver bullet” that would eliminate all issues with the current healthcare system. He said it’s a good framework to start improving access to care, noting the momentum from communities like Amherst, Northampton, Brookline, and others that have passed resolutions for similar Medicare for All bills.

“It feels like there is some more momentum here as more cities and towns sign onto this and show people what their personal savings can be, and what employers can realistically save,” Smith said. “Employers should be able to pay people more with those savings, or hire more people. People should be able to leave their jobs and not worry about their health care. People should also be able to go to a doctor and not worry about how they’re going to pay for that.”

House Bill H.1405 is before the Joint Committee on Health Care Financing, with a reporting date of June 15. Senate Bill S.860 is currently in the committee on Health Care Financing with a study order as of Jan. 29.

Michael McHugh can be contacted at mmchugh@northofboston.com or at 781-799-5202

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