Tag: Department of Public Health

  • In MA, Doctors’ Day becomes rallying point for health care reform

    While Doctors’ Day has traditionally celebrated physicians’ contributions — specically the date of the first use of general anesthesia in surgery by Dr. Crawford W. Long on March 30, 1842 — this year Massachusetts physicians are redefining it as a platform for advocacy.

    Facing federal funding cuts and growing primary care shortages, Massachusetts physicians met with legislators on March 25 at the State House to call for urgent policy action. Physicians from the Massachusetts Medical Society gathered for their first in-person Doctors’ Day since before
    the COVID-19 pandemic to advocate for bills to increase primary care access, improve childhood immunization rates, and bolster protections for immigrant health care access.

    The renewed urgency comes as the “Big Beautiful Bill,” passed by Congress last July, is expected to cut $3.5 billion annually from federal health care funding to Massachusetts. The cuts amount to about 5% of the state’s proposed total budget for fiscal 2027. This will lead to about 326,000 residents losing health care insurance coverage, according to a minority report of the Joint Economic Committee, based on a report by the Congressional Budget Office. “I’m proud of the advocacy this day represents, but I encourage you to do more,” Dr. Kiame Mahaniah, the state’s secretary of Health and Human Services, told physicians. Mahaniah emphasized that physicians play a critical role in clinical care, but must also advocate for the broader health care system throughout the state.

    An aging workforce means a shrinking workforce

    Access to primary care physicians has been declining across Massachusetts, and is expected to face greater threats as cuts to Medicaid take effect later this year, according to a recent re-
    port by NPR. More than half of in-office physicians are age 55 or older, raising concerns about a shrinking workforce, according to Mahaniah.

    State Sen. Cindy Friedman, D-Arlington, co-chair of the Legislature’s Committee on Health Care Financing, highlighted the growing strain on the system, as colleagues consistently ask her, “Can you help me get a primary care physician?” Friedman championed several of the bills discussed at the March 25 event.

    Throughout the state, primary care represents a small and declining share of total health care spending. This leads to increased strain on emergency departments, according to a presentation from Mass. Medical Society reps.

    Physicians advocated for the future of their profession by promoting passage of several bills designed to strengthen primary care access.

    Among those proposals is one that would double the investment in primary care over four years, with a target of at least 12% of total health care spending allocated to primary care departments. It would also establish a primary care stabilization fund to deliver payments directly to practices, an idea that Mahaniah and other speakers advocated for throughout the meeting.

    Physicians also raised concerns about administrative burdens tied to insurance companies’ prior authorization requirements, an issue they say leads to unnecessary costs and often causes pa-
    patients to forgo needed treatment.

    The bill, aimed at reducing delays in patient care and administrative burden, would strengthen oversight and improve timely access to treatment.

    Addressing declines in vaccination rates

    In addition to administrative and industry issues, physicians also advocated for pressing public health concerns as nationwide threats to vaccine and immigration policies begin to take effect
    in Massachusetts.

    In early January, the Centers for Disease Control and Prevention reduced the number of recommended vaccines for children. Massachusetts has seen declines in vaccination rates in recent years, as well as a record high number of non-medical religious exemptions, according to the Mass. Medical Society.

    In some school communities, vaccination rates have dropped below herd immunity thresholds — the point at which enough people in an area have protection from a disease that it no longer spreads easily, according to the Mass. Medical Society. Vaccination ex-
    emption rates among kindergarten students are rising in central and western counties, with 1.6% exempt in Worcester County and 2.7% in Hampden County. In Middlesex County, 1.2% of students had exemptions, while in Suffolk County the rate was 0.8% for the 2024-25 school year, according to the Department of Public Health.

    Another proposal would require all public and private schools to report immunization data annually to the Department of Public Health, while ensuring that necessary medical exemptions are maintained.

    Physicians also advocated for a provision in a supplemental budget proposal, offered by Gov. Maura Healey, that calls for protecting health care facilities from civil immigration enforce-
    ment actions, with the goal of reducing appointment cancellations and no-shows. The bill would restrict immigration agents’ access to health care facilities, requiring a judicial warrant to en-
    ter medical facilities.

    The House-approved PROTECT Act would restrict local law enforcement’s cooperation with ICE. However, the act does not designate health care facilities as sensitive locations.

  • Examining Marblehead school vaccine rates

    As controversy over childhood vaccinations rages nationwide, student immunization rates in Marblehead have remained steady over the past three years, with most schools reporting 90% or more of pupils have gotten all vaccines required by state law.

    Dr. Thomas Massaro, a retired pediatrician and the chair of the town’s Board of Health, said the community’s demographics likely play a key role in maintaining consistent vaccination rates.

    “Massachusetts is a pretty progressive state, and Marblehead is consistent with that,” he said. “About 77% of residents have at least one bachelor’s degree, and it’s an affluent community. People understand the benefits of vaccines, they judge them, and they decide to go ahead.”

    Statewide, the number of students with all vaccines required for school averages 94.4% for kindergarten students and 90.7% for grade 7 students. Pupils in some parts of Massachusetts are getting vaccinated less and requesting more exemptions in recent years, Department of Public Health data shows. Vaccination rates have been decreasing nationally since the COVID-19 pandemic, especially for kindergartners and as more parents question their effectiveness, though Massachusetts was recently rated by one national study as the state with the highest vaccine rates for all residents.

    State and local governments have the authority to impose vaccine requirements for students in their communities, though the U.S. Centers for Disease Control has traditionally recommended a vaccine schedule for those attending school. The CDC announced this month it was dropping recommendations that school-age children get six vaccines previously encouraged for students, including those aimed at preventing respiratory infections, Hepatitis A and B, and meningitis. Gov. Maura Healey, a Democrat, immediately announced students in Massachusetts would still be required to get all vaccines mandated by state law, which include some of those eliminated by the CDC.

    Massachusetts children, from those attending day care and pre-school programs through those attending college in the commonwealth, are required to get a slate of vaccines as they progress through grades, including those preventing chickenpox, polio, diphtheria and measles, among others.

    In December, state officials issued an alert about potential measles exposure in Massachusetts after an out-of-state visitor contracted the disease. Since 2020, there has been only one case of a Massachusetts resident getting the measles, state records show.   

    But for the first time in three decades, the number of measles cases in the U.S. rose to over 2,000 last year, according to the CDC. All 50 states require vaccinations for students, though Republican Florida lawmakers, including Gov. Ron DeSantis, have been battling to limit vaccine requirements. 

    Each year, the Massachusetts DPH surveys all day care, pre-school and kindergarten programs and middle and high schools, to gather immunization data on those in seventh and 12th grade.  Those grade levels are targeted to align with the required state-required vaccines for children of those ages. 

    Students can request a medical exemption from the vaccines if certified by their physician or a state can waive exemptions if mandated immunizations conflict with a student’s religious beliefs. Like the rest of the nation, medical and religious student vaccine exemption rates in Massachusetts have risen in the past four years, according to data shows. 

    In Marblehead, exemption rates across all programs and schools have hovered between 0% and 6% at the highest since 2022, DPH data shows. A bill pending in the Massachusetts legislature would remove the ability for a student to obtain religious exemptions, mirroring New York, Maine and Connecticut and California, which have eliminated them. 

    Massaro said the pandemic undermined public trust in government across age groups.

    “One of the long-term negative consequences of the pandemic was a loss of faith and trust in public health,” he said. “Vaccines are the prime face of public health to young people. If the pandemic caused overall questions about whether they can trust the CDC or FDA, then it’s not surprising there’s been a slight diminution.” 

    Massaro also warned that misinformation circulating at the federal level may further undermine confidence. 

    “We’re subject to a much bigger decline with all the misleading information coming out of (the U.S. Department of) Health and Human Services right now,” he said.

    Polls by the Kaiser Family Foundation show widening partisan divides over support for routine childhood vaccinations. At the same time, states have begun to diverge significantly in how they regulate school immunization requirements. New York and California eliminated nonmedical exemptions after large measles outbreaks in the past decade. Other states have moved in the opposite direction. Idaho, Oklahoma and Utah have expanded or clarified access to exemptions, reflecting the broader national debate. 

    “It is a balance between the individual and the community,” Massaro said. “People need to trust the systems that protect them.”