How the candidates for Massachusetts governor would tackle health care

The COVID threat is lingering. Inflation is driving up medical costs. Staffing shortages are threatening access to health care.

The next Massachusetts governor will have to grapple with these challenges and more.

Democrat Maura Healey targeted health care costs from her first days as attorney general in 2015. She played a role in slowing the growth of the state’s biggest and most expensive health system, Mass General Brigham. Healey allowed the big hospital merger that created Beth Israel Lahey Health, but only after the hospitals agreed to cap their prices for seven years.

Diehl, a former state lawmaker, says Healey hasn’t done enough to protect consumers from high costs, while Healey accuses Diehl of fighting for policies that would raise costs and hurt Massachusetts residents. She cites his past opposition of the Affordable Care Act, which Healey fought to preserve.

So how would the candidates tackle health care and its many challenges as governor? Here’s what they told WBUR:

The vast majority of Massachusetts residents have health insurance, but 41% had trouble paying for health care last year, according to a state survey.

Healey and Diehl both say they want to make care more affordable. Healey says she would do this through greater accountability and oversight of the health care industry, though she didn’t specify how.

“I've spent a lot of time on health care over the last eight years, and certainly there are any number of challenges,” Healey told reporters during a recent campaign stop at UMass Boston's nursing school. “One is affordability. We don't have accessibility if we don't have affordable health care.”

Diehl’s campaign manager, Amanda Orlando, said he wants to give consumers more information and more choices of health insurance plans and hospitals.

Healey has not said whether she would require masks in the event of another COVID surge. She has praised Gov. Charlie Baker’s handling of COVID and said she, like Baker, would “follow the science” to manage the evolving threat.

Healey also supports COVID vaccination mandates for state workers.

Diehl, however, has put his opposition to vaccination requirements at the center of his campaign. He says they infringe on personal freedom.

“I’m not anti-vaccine, I’m not anti-mask — I just want people to be able to make their own choice on that,” he said in the last gubernatorial debate. “You should have the choice with your lives to get the health care that you decide — not government forcing it on you.”

Diehl and Healey both list mental health care as a priority, though neither say exactly how they would expand access to treatment.

Diehl’s campaign manager, Orlando, said Diehl is concerned about the mental health of children “who were ignored during the pandemic and suffered for it.”

“We also need to expand these services into the suburbs,” Orlando said in an email, “to help stem the tide of young people getting addicted to drugs in our suburban communities without access to preventative care to assist them away from those choices.”

Healey, in 2019, reached landmark agreements with the state’s biggest insurers to remove barriers for patients trying to access mental health treatment.

She has drawn national recognition for her lawsuits against Purdue Pharma and other companies for their role in spawning the opioid epidemic. She helped negotiate settlements that include millions of dollars for Massachusetts cities and towns to respond to the opioid crisis.

As governor, Healey says, she would invest in mental and behavioral health care, including treatment for people with substance use disorder.

“I know the importance of that for families across the state, from people of all walks of life,” she said. “We need to do the work as a state to increase those resources.”

The U.S. Supreme Court overturned the constitutional right to abortion in June, but abortion remains legal in Massachusetts.

Healey says she will protect access to abortion and “make sure that women are able to access the health care that they choose and need.”

Diehl says while he personally opposes abortion, he won’t try to change abortion rights in Massachusetts. “Abortion will be protected when I’m governor,” he says.

Healey has said she doesn’t believe that.

Both candidates said they would work to grow the health care workforce. The pandemic exacerbated staffing shortages, and hospitals and other health care facilities have been struggling to fill jobs.

Healey also cited health equity as a priority. She said her administration would invest in medical care as well as things like safe and affordable housing, which have an impact on health.

The governor's administration oversees many aspects of health care, from running the state Medicaid program, to regulating hospitals and insurers, to shaping policy through legislation.

Donald Berwick, senior fellow at the Institute for Healthcare Improvement, said the next governor needs to prioritize cost control. Berwick ran unsuccessfully for the Democratic nomination for Massachusetts governor in 2014 and now supports Healey.

“This cost is eroding the well-being of small businesses. A lot of it is coming out of the pockets of the people of Massachusetts, including people of relatively marginal incomes. And something really needs to be done about it,” Berwick said.

“We never have gotten traction on health care costs as a commonwealth.”