WITH THREE state-funded youth mental health programs at risk of closing, lawmakers and providers ramped up their opposition this week to Gov. Maura Healey’s proposed budget cuts that come as Massachusetts continues to grapple with a behavioral health care crisis.

Two 15-bed intensive residential treatment programs (IRTP), operated by NFI Massachusetts in Westborough, that serve teenagers with serious mental health and safety issues would close under Healey’s fiscal 2026 spending plan. That would leave just two other IRTPs in the state.

The governor’s budget would also shutter the state’s only clinically intensive residential treatment (CIRT) program, called Three Rivers in Belchertown, that has a dozen beds and treats children ages 6 to 12.

At a budget hearing Monday in Attleboro, Department of Mental Health Commissioner Brooke Doyle said those facilities are slated to close due to low patient counts, inadequate staffing and location hurdles. The cost-saving measure comes as DMH — which would receive a 7 percent overall budget increase under Healey’s proposal — looks to prioritize resources for its over-capacity psychiatric hospitals.

“These programs have been very difficult to maintain adequate and safe staffing within. They’ve been understaffed for extended periods of time, and that has contributed in large part to why we had difficulty keeping all the beds filled,” Doyle said in Attleboro. “The programs do provide a specialized service need, and the reality is, that we haven’t been able to operate them fully today. So what we’re proposing to do is to right-size the IRTP, reflecting the volume that does get utilized.”

Doyle said the state pays for those beds “in full,” regardless of whether or not they are occupied. She argued that makes it “not sustainable to continue to pay for 50 percent utilization.”

Doyle highlighted the state’s investment in community-based mental health resources, though the IRTP and CIRT programs are seen as a last resort to stabilize young patients who repeatedly end up in the hospital and pose significant safety risks to themselves and their family.

“Without these services, youth will continue to cycle through expensive and disruptive emergency and acute hospital services,” Lydia Todd, executive director of NFI Massachusetts, said at a State House budget hearing Tuesday, according to a copy of her prepared remarks. “Their families face income loss because it is impossible to maintain employment when they are regularly needed to respond to mental health crises.”

Todd added, “If this program is closed, the commonwealth will lose a recently renovated facility, a highly credentialed, experienced and skilled multi-disciplinary team of 95 staff, a Joint Commission-accredited program, and most importantly, the ability to help youth and families with the most serious needs to manage their mental health issues in their natural communities, and be less likely to end up in one of our adult systems.”

Todd told the News Service 95 out of 100 positions are filled. 

“We could be fully utilized — no problem,” she said. 

Program leaders and lawmakers contend the programs are underutilized due to a complicated DMH referral process that can leave youth languishing in hospitals for weeks or months before they secure placement. Due to high staff turnover during the COVID pandemic, some hospital mental health providers also were unaware the IRTP and CIRT programs existed, said Sen. Jake Oliveira of Ludlow. 

“It’s my hope that we can restore the funding for these critical programs because everything that we hear from constituents and everything that we read, there is a dire need for youth beds, particularly adolescent mental health beds throughout Massachusetts,” Oliveira told the News Service. “If we have programs that are underutilized, then DMH needs to do a better job with the referral process to get help to families across Massachusetts.”

Doyle admitted the referral process was “too clunky” at the hearing Monday.

“So I’ve actually made some changes to that referral process, going to preview it with stakeholders this month, with a go-live plan for May,” Doyle said.

In another major budget cut, DMH plans to slash the case management workforce in half, which would save the state $12.4 million. That move recently triggered DMH workers represented by SEIU Local 509 to take a vote of no confidence in Doyle. 

Gov. Maura Healey has already hit pause on a controversial plan to shutter a 16-bed psychiatric hospital in Cape Cod. That closure, combined with the three youth mental health programs, would have saved the state a total of $20.1 million, according to a presentation from the Executive Office of Health and Human Services.

As House Democrats prepare to release their budget next week, Rep. Aaron Saunders of Belchertown said he plans to fight to ensure the CIRT, operated by Cutchins Programs for Children & Families, receives funding.

“We need it to be there,” Saunders told the News Service. “It is a level of intervention and service that other programs are not designed to provide, and that to me really is the linchpin.”

Saunders added, “In my conversations with the administration, I’ve tried to impress upon them that there needs to be access, in some way, shape or form, to this level of service.”

Tina Champagne, CEO of Cutchins Programs for Children & Families, urged lawmakers Tuesday to “dig deeper and to save our programs.” In prepared remarks, Champagne said the state remains in the throes of a “children’s mental health crisis” and argued “this is no time for a reduction in intensive mental health services in our state.”

“The decision to cut the CIRT is not only in direct opposition to well-established evidence-based practices for children and families with some of the most persistent and challenging mental health and safety concerns, but also puts the the most vulnerable children and families in the commonwealth at even greater risk by perpetuating the cycle of ACES and traumatic experiences,” Champagne said, referring to adverse childhood experiences.

She added, “The degree of safety and mental health challenges that must occur for youth to be considered for a DMH referral for the CIRT is highly intensive and the youth’s safety concerns are typically quite serious. If these youth could be treated elsewhere in the community, they would have been referred to those services, and usually have already utilized these services, but they are not intensive enough to maintain safety and mental health stabilization.”

At the hearing, Oliveira told Doyle he was insulted by her remarks that signaled the Belchertown program was not viable due to its location in western Massachusetts.

“That’s insulting to any western Mass. lawmaker who might be sending people halfway across the state, hours away to get the programs to utilize them,” Oliveira said.

The commissioner told Oliveira she regretted if her testimony seemed to be “disrespectful.”

“It’s more of a matter that we have to weigh parents’ requests and parents’ priorities, as well,” Doyle said. “So, it has always been a western Mass.-located program. It’s not new. And what we’re seeing is that it is getting a bit more challenging, particularly with workforce constraints, that when we don’t have full staff operating, it requires that the department have to make decisions with parents about whether or not their their child can be safely treated in that environment, based on staff that are available at that time.”

Rep. Kelly Pease, a Westfield Republican, questioned whether the adolescent mental health programs represented the “smart place” for DMH to make cuts. Without providing sufficient care to young Bay Staters early on, the state may exacerbate the prison pipeline and end up incurring more costs in the future, Pease told Health and Human Services Secretary Kate Walsh.

Walsh insisted those programs were 50 percent occupied and emphasized EOHHS’s push to “right-size our behavioral health infrastructure.” Pease argued the low patient census was a function of DMH’s “antiquated process to get a referral.”

“I think the question for the Legislature is: Do you want to pay for standby capacity in two or three programs across the state that may or may not be used?” Walsh said at the hearing Monday. “In the meantime, you should challenge us to significantly improve our antiquated or very complicated processes to get people into these systems — some of which, I will remind us, were the result of court decisions. So we have patient referral pathways for people with, for children with behavioral health challenges that were built by lawyers, with due respect.”

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MIKE KENNEALY, a former private equity manager who spent four years as state housing and economic development secretary under Gov. Charlie Baker, declared his candidacy for governor on Monday and said Massachusetts is “heading in the wrong direction.” 

Jumping into the ring against Gov. Maura Healey, who plans to seek reelection in 2026, Kennealy released a launch video Monday morning. He pointed to rising expenses, education, the emergency family shelter crisis and outmigration as key areas where the Bay State is struggling.

“The political class on Beacon Hill is more concerned with their future than with ours. Our beacon on a hill has become a beacon in the rearview mirror,” Kennealy said in the video. “The people of Massachusetts expect and deserve better.”

Although the press release announcing Kennealy’s campaign launch made no mention of his party affiliation, a spokesperson confirmed he is running as a Republican.

Other Republicans mentioned as potential candidates for governor include Worcester County Sheriff Lew Evangelidis, former MBTA Chief Administrator Brian Shortsleeve, former U.S. Senate candidate John Deaton, and Sen. Peter Durant, who said last month he would make his decision “relatively shortly.”

Kennealy spent nearly two decades working in private equity before joining the public sector in 2013 as part of the leadership team that worked on turning around Lawrence Public Schools, according to his campaign.

He became an assistant secretary under Baker, and rose to the Cabinet-level role of housing and economic development secretary in December 2018. Healey, who succeeded Baker, later split that job into two separate positions of housing secretary and economic development secretary.

Kennealy stayed in that job for the remainder of Baker’s tenure through 2022, helping to lead the state’s response to the economic upheaval inflicted by the COVID-19 pandemic. Following his time on Beacon Hill, Kennealy worked as senior advisor and chief strategy officer at the Boys and Girls Club of Boston.

His campaign appears poised to spotlight affordability issues, a steady theme on Beacon Hill for Healey and the House and Senate Democratic supermajorities. Kennealy named “a state we can all afford” as his top priority, followed by “a great future for everyone” and “government we can believe in.”

Healey in February announced her intention to seek reelection, saying she believes “there’s a heck of a lot more to do.”

Massachusetts voters over the years have elected a succession of Republican governors while preferring to keep Democrat supermajorities in the House and Senate, as well as an all-Democrat congressional delegation.

A UMass Amherst-WCVB poll of Massachusetts voters conducted in mid-February found about 52% approve of Healey’s job performance so far compared to 36% who disapprove.

Pollsters also asked at the time about hypothetical matchups between Healey and potential Republican challengers, including Kennealy. Four in 10 voters said they’d back Healey over Kennealy, 15% said they would pick Kennealy, and another 39% were not sure.

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ON THE EVE of a legislative hearing on her surtax surplus plan, Gov. Maura Healey submitted another spending bill for the Legislature’s review, filing a $756 million supplemental budget she said would address “time-sensitive deficiencies” in state government accounts.

The proposal Healey filed Wednesday afternoon (HD 4540) includes $134.5 million for supplemental payments to safety-net hospitals, $60 million for direct care for older adults, $240 million for state employee health care costs through the Group Insurance Commission, and more. It would carry a net state cost of $544 million after federal reimbursements, she said.

Healey’s office pitched the $190 million the bill includes for a child care financial assistance program as a way to “support Massachusetts residents at a time of rising costs.” Another $43 million would go toward the Residential Assistance for Families in Transition (RAFT) program that offers aid to families facing potential eviction, which has faced increasing demand during a period of housing strain.

The legislation additionally includes $15 million for grants and marketing related to the American Revolution 250th anniversary celebration, and $15.5 million for more secure electronic benefits transfer cards that Healey said would “help combat food benefit theft.”

“This budget bill proposes targeted investments that improve quality of life in Massachusetts, such as ensuring access to health care, supporting families with child care costs, and making sure veterans get their benefits,” Healey said in a statement alongside the bill. “We’ve also heard clearly from local officials and medical professionals across the state, especially in communities impacted by Steward Health Care’s closures, that they need more support. That’s why we’re proposing significant funding for EMS providers that have faced extraordinary costs. Our administration remains committed to maintaining a responsible state budget that tangibly benefits the people of Massachusetts.”

Other sections of the 25-page bill would ratify collective bargaining agreements with public employees, raise procurement thresholds under public construction laws, and allow Massachusetts Emergency Management Agency vehicles to use red and blue lights when responding to emergencies.

The Legislature’s Joint Committee on Ways and Means is partway through a series of hearings about Healey’s $62 billion fiscal 2026 state budget, and the panel will meet Thursday to consider Healey’s separate $1.3 billion proposal (H 55) to spend surplus surtax revenue.

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TALKS ARE UNDERWAY within state government about establishing a third long-term care home for veterans, Veterans Services Secretary Jon Santiago said Tuesday.

At a Joint Ways and Means Committee hearing in Worcester, the secretary described the next budget cycle as being about the “organizational maturation” of the Executive Office of Veterans Services.

The office became a Cabinet-level office two years ago after governance and operational shortcomings that proved fatal during the pandemic, particularly at the state-run veterans’ homes in Holyoke and Chelsea. He described how things are going at the new Chelsea facility that opened in 2023 and the work underway to prepare for the under-construction new Holyoke home.

Santiago also raised the subject of a $200 million bond authorization that the Legislature, where he served at the time, included in a 2021 law to address long-term care for veterans in other parts of the state.

“There was a $200 million bond bill put forward to look into a third home, right, to increase that geographic equity. That’s something that we’re in a conversation with [the Division of Capital Asset Management and Maintenance], to look where across the Commonwealth we could potentially put a third home and what that would entail,” the secretary said.

The authorization to borrow up to $200 million in the 2021 law is specifically for “increasing geographic equity and accessibility related to the continuum of long-term care services for the Commonwealth’s veterans not primarily served by the Soldiers’ Home in Massachusetts located in the city of Chelsea or the Soldiers’ Home in Holyoke, including the establishment of regional or satellite veterans’ homes.”

The potential for a third state-run veterans’ home came up during a back-and-forth between Santiago and Rep. Russell Holmes of Boston, who asked the secretary about the diversity of the resident veterans served at the state-run facilities.

“It always feels like the Chelsea and the Holyoke homes feel like they’re local, they’re for local people. That’s just historically how they’ve felt; people in the west thought it was for them in the west, people in the east thought Chelsea was for the east. And as you grow from 117 beds, it sounds like, to 234 in Holyoke. And then as you now opened up Chelsea, do you have an answer on diversity of the residents who’s living there?” Holmes asked.

The representative said he was particularly interested in knowing how the state plans to make the additional beds that will come online in Holyoke available and what outreach will be done to make sure all veterans know their options.

“My understanding is, historically, it’s kind of been, you know, who you knew helped you get in. I hope we’re eliminating all of that as a part of this new process,” Holmes said.

Santiago said he “completely agree[s]” with Holmes about the way the Chelsea and Holyoke homes have been viewed. He said the “vast majority of residents there are white male” and told Holmes that while the “current mechanism is a ‘first come, first served’ ” method of accepting new veterans to the homes, it’s something he wants to look at it as part of a 2030 strategic plan.

“Part of that is looking into how we make sure veterans who are underserved, irrespective of their race, maybe, or their gender, are cared to. We have 25,000 women veterans across the commonwealth. Traditionally, they have not gotten the services, respect, that they have fought for and that they have earned,” he said. “And so we’ve changed our management, we’ve changed our programs and policies to better address that, and we look forward to doing it with the veterans of color as well.”

If the state is going to establish a third home, Rep. Kip Diggs of Barnstable said it should be on or near Cape Cod.

“We have 19,000 veterans on the Cape … and what’s important to me is if that third spot, maybe we can get it closer to the Cape. Because, honestly, it’s all about taking care of my area and making sure — you know, our veterans have done so much and asked for so little,” he said. “So I think it’s something that’s just so poignant and so necessary that we bring something down towards the southern part of Mass.”

The secretary responded briefly to point out the “significant cost” that would be associated with any potential third facility. Others, including Sen. John Velis of Westfield, have previously mentioned that conversations about additional veterans facilities were taking place.

Lawmakers dug into a variety of topics with Santiago during their time for questions. Sen. Kelly Dooner of Taunton put a pitch in for finding a way to partner with a nonprofit to repurpose parts of Taunton State Hospital for veteran housing, Sen. Michael Brady of Brockton wanted to know about the impact so far and outlook for additional federal cuts at the VA, Rep. Judith Garcia asked about veteran needs that are not met through the state budget appropriation, and Sen. Ryan Fattman pressed officials on the need for better tracking of suicides among veterans here and especially among Mass. National Guard members.

Santiago said Healey’s budget proposes $206 million for his secretariat, $7.6 million more than the current state budget. He said the budget proposal includes an increase of $13.6 million to veterans benefits and annuities, as well as $80 million to support the state-run veterans homes in Chelsea and Holyoke.

“This overall allotment helps us maintain critical staffing, supports infrastructure improvements, allows us to operate and maintain our two veteran cemeteries in Winchendon and Agawam, and provides health care and supportive services to veterans at the long-term care and independent living facilities in Chelsea and Holyoke,” Santiago said. “We are particularly proud of the transformation happening at both veteran homes over the past two years. They both continue to show progress when it comes to modernization and quality of care, ensuring that Massachusetts veterans receive the highest standard of care.”

Chelsea Veterans Home Superintendent Christine Baldini told lawmakers that the implementation of electronic medical records was a “significant milestone” for her facility.

“This is transforming our health care operation. By replacing traditional paper records with a secure, integrated, digital platform, we have enhanced accuracy, reduced administrative burden and improved overall efficiency. Real-time access to resident information empowers the care team to make informed decisions more quickly, and fosters streamlined communication across all disciplines,” she said.

Holyoke Superintendent Michael Lazo said his team is preparing to expand into the new 234-bed facility the state broke ground on in August 2023. He told the Ways and Means Committee that the larger and modern facility “will require approximately 40% increase in workforce spending, both clinical and non-clinical roles.”

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AT A TIME when lawmakers are wrestling with cost, access and regulatory questions, health care industry power players continued to dominate the Beacon Hill lobbying world last year, spending the most on employing influential insiders who sway development of public policy.

The Massachusetts Association of Health Plans spent $1.3 million on lobbyists in 2024, more than any other individual client in the Bay State, according to data from Secretary of State William Galvin’s office. The organization representing insurers newly supplanted the Massachusetts Health and Hospital Association, which topped lobbying spending in 2022 and 2023 but ranked second last year with $1.1 million.

Those organizations were the only two clients that spent more than $1 million apiece on lobbying last year.

Many health care- and pharmaceutical-adjacent groups ranked near the top in 2024 lobbying spending, too, including the Massachusetts Biotechnology Council ($866,139), Massachusetts Nurses Association ($519,191), Blue Cross Blue Shield of Massachusetts ($460,403) and the Association for Behavioral Healthcare ($459,070).

Health care policy is one of the thorniest and most complex topics for lawmakers to tackle. The Legislature enacted a pair of major reform bills in 2024, including one intended to lower prescription drug costs and another imposing more financial oversight on hospitals following the collapse of Steward Health Care.

But the problems plaguing both providers and patients remain potent. Sen. Cindy Friedman, the Senate’s point person on health care reforms, warned last week that the health care system is “falling apart.”

The total amount paid to lobbyists by all clients across different topics crossed into nine figures in 2024, climbing to $104.1 million.

The same top lobbying shops continue to command the most money from clients.

Each of the five top-earning firms in 2023 retained the same ranking in 2024, led by Smith, Costello and Crawford, which hauled in $6.2 million last year.

Like many lobbying entities around Beacon Hill, Smith, Costello and Crawford counts well-connected former public officials among its ranks. The firm is partly led by former Democrat Reps. Michael Costello, and another former representative, Carlo Basile, is a senior policy advisor. That’s the same title held by Marylou Sudders, who served as health and human services secretary under Gov. Charlie Baker.

Smith, Costello and Crawford’s top-paying client — $180,000 last year — was energy giant Avangrid, a key figure in the state’s push to build out cleaner energy sources including offshore wind.

Tremont Strategies Group earned the second-most of any lobbying firm with about $4.5 million. Former Congressman Chet Atkins, who also served in the Massachusetts House and Senate, is a partner at Tremont.

Rounding out the five top-earning firms were O’Neill and Partners ($4.28 million), Dempsey Associates ($3.77 million) and Kearney, Donovan and McGee ($3.5 million).

The next five ranking spots were all captured by the same firms as 2023, but in a slightly different order. ML Strategies jumped from seventh-most in earnings in 2023 to sixth-most in 2024, flipping with Bay State Strategies Group. Similarly, Issues Management Group climbed from ninth in 2023 to eighth in 2024, swapping places with TSK Associates. The Suffolk Group landed in 10th both years, earning about $2.26 million in 2024.

No individual lobbyist earned more in 2024 than former Senate President Robert Travaglini, who founded what is now known as TSK Associates after leaving the Legislature.

Travaglini hauled in $854,000 from his lobbying clients in 2024, according to data from Galvin’s office. Basile, who was the top earner in 2023, landed in second last year with $830,000 in lobbying salary.

The private sector can be much more lucrative for lawmakers than remaining in the Legislature. The current Senate president, Karen Spilka, earned $203,286 in total pay last year, according to state payroll records, less than one-quarter as much as Travaglini brought in from lobbying clients.

Fourteen lobbyists earned more than half a million dollars from their firms last year, and 56 brought in at least $250,000.

Three other registered lobbyists were paid at least $250,000 directly by clients: Mass. Association of Health Plans President Lora Pellegrini ($469,233 from MAHP), Clark University Vice President for Government and Community Affairs Joseph Corazzini (nearly $235,000 from the Trustees of Clark University), and OpenCape CEO Steven Johnston ($246,159 from OpenCapeCorporation).

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ANNUAL STATE BUDGET hearings got off to a late start this year, but lawmakers packed two hearings into three business days before pausing for an unusual two-week break that is coinciding with a general lack of activity among all legislative committees 10 weeks into the new session.

While it doesn’t explain the full length of the pause, nearly a dozen lawmakers, including the chairs of the House and Senate Ways and Means committees, were out of the country recently for three days.

In response to a News Service inquiry about the longer-than-usual break in budget hearings and possible out-of-state travel, aides to House Speaker Ron Mariano and Senate Way and Means Chairman Michael Rodrigues said 11 legislators, all Democrats, left for Canada on Thursday with plans to return Saturday.

Rodrigues spokesman Sean Fitzgerald called it an “alternative energy fact finding trip.”

In an email late Friday, Fitzgerald called the visit “part of a broader strategy to explore affordable, sustainable, and renewable forms of carbon-free energy” and said the legislators planned to tour the HQ James Bay Generating Facility, which is part of Hydro-Québec’s operations. 

“The facility is a two-hour propeller plane flight out of Montreal and is one of several options to ensure the availability and viability of New England’s energy future,” Fitzgerald said. “With uncertainty at the federal government occurring in all sectors of the American economy, it is especially important to maintain the partnership with Hydro Quebec as one avenue to help meet the Commonwealth’s renewable energy goals and future grid demand.”

The trip comes as state energy policies shaped through a series of clean energy laws are suddenly at odds with the new direction of federal energy policy under President Donald Trump.

State policies are geared toward compliance with strict carbon emission reduction mandates, while US Energy Secretary Chris Wright this week emphasized “the critical role of fossil fuels in meeting global energy demands,” according to the energy department, and hyped the the need to “end the Biden administration’s irrational, quasi-religious policies on climate change that imposed endless sacrifices on our citizens.”

In the last week, the US Department of the Interior approved a plan to extend the operational life of Montana’s Spring Creek Mine by 16 years, enabling the production of nearly 40 million tons of coal. The US Department of Energy signed a major liquefied natural gas export permit approval, the White House said, and the Environmental Protection Agency launched the “biggest day of deregulation in American history.”

State officials in Massachusetts also face new and serious questions about federal support for ongoing and future clean energy efforts. As Trump looks to build jobs in fossil fuel-based energy, plans in Massachusetts to grow jobs and produce a major new supply of clean power through offshore wind projects are in doubt.

Sen. Ed Markey and eight other US senators released a letter Friday demanding that EPA Administrator Lee Zeldin “cease his illegal witch hunt to claw back nearly $20 billion in congressionally appropriated and legally obligated funds that underpin the Greenhouse Gas Reduction Fund.” The fund is designed to “spur economic development, lower energy costs, and reduce pollution,” Markey said.

Ana Vivas, a spokeswoman for Mariano, said in an email Thursday night that legislators planned to visit the Hydro-Québec Research Institute, the dikes, dam and spillway that are part of the Robert-Bourassa hydroelectric facilities, and an underground generating station that she said are part of “the largest hydroelectric facility in North America” and include a dedicated transmission line to Ayer, Massachusetts.

Budget hearings paused after a March 10 hearing in Gloucester and will resume March 24 in Amherst, starting a string of four budget hearings in six business days. After two final budget hearings in April, the House Ways and Means Committee plans to release its redraft of Gov. Maura Healey’s $62 billion budget during the week of April 14, with floor debate scheduled for the week of April 28.  Healey filed her budget Jan. 22. The Legislature has made a habit of not completing annual budget by the July 1 start of the fiscal year.

Rodrigues, Sens. John Cronin and Jacob Oliveira were on the trip, according to Fitzgerald. Cronin is a member of the Legislature’s Joint Committee on Telecommunications, Utilities and Energy.

House members who went on the Canada trip included Rep. Mark Cusack, the new House chair of the Committee on Telecommunications, Utilities and Energy, and vice chair Rep. Michael Kushmerek. Senate co-chair Sen. Michael Barrett and vice chair Michael Brady were not listed as trip participants.

Rep. Jeff Roy, who Mariano moved off his former Energy Committee chairmanship and up into his leadership team, was also on the trip to Canada. Roy has been the focus of Boston Globe reporting over his relationship with an energy sector lobbyist.

The other House members who went to Canada, according to Vivas, are Ways and Means Committee Chair Aaron Michlewitz, Rep. Danielle Gregoire, Rep. Kathy LaNatra, Rep. Meghan Kilcoyne and Rep. Michael Finn. None of those representatives are among the House members of the Energy Committee.

Fitzgerald said senators on the trip were responsible for paying for transportation, lodging and expenses.

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ELIGIBLE MASSHEALTH members and Health Safety Net patients will have access to prenatal vitamins and over-the-counter birth control at no cost, under two standing orders that the Healey administration announced Thursday.

The orders, which essentially enable the state to write a prescription for a large group of people, will allow about half a million patients to access the reproductive health medications.

The medications will be available at all MassHealth-enrolled pharmacies, and available for eligible MassHealth members and those who use the Health Safety Net, a fund used to pay care costs for certain low-income and uninsured individuals.

MassHealth currently covers 40 percent of all births in Massachusetts, according to the Healey administration.

“Removing barriers like this is one of the simplest ways we can work toward better health outcomes for mothers and infants in our state,” Health and Human Services Secretary Kate Walsh said.

The standing order covers a 90-day supply of over-the-counter prenatal vitamins or multivitamins containing at least 400 mcg of folic acid, a B vitamin that helps bodies create new cells. Doctors recommend that people considering getting pregnant, pregnant, or nursing, take these vitamins.

Pharmacists will be required to counsel patients on the use of prenatal vitamins, including when to start and stop taking them, and encourage follow-up with a primary care provider and obstetrician/gynecologist.

The second standing order covers oral hormonal contraceptives. It allows pharmacists to give out a 365-day supply of over-the-counter birth control pills — specifically norgestrel 0.075 mg tablets — to eligible MassHealth members and HSN patients.

It specifies that birth control is “accessible to individuals of reproductive potential and age,” according to Healey’s Executive Office of Health and Human Services (EOHHS).

“As part of this initiative, pharmacists will be required to counsel patients on contraindications, side effects, and the proper use of the birth control pill, emphasizing the importance of daily adherence and informing patients that the pill does not protect against sexually transmitted infections,” information from EOHHS says.

“We know that prenatal vitamins and birth control play an essential role in women’s health. No one should be prevented from getting the care they need because of cost or because they are waiting for a prescription,” Healey said in a statement. “These standing orders will make it easier and more affordable for people to make the best health care decisions for themselves, will improve health outcomes for women and babies, and will reduce health disparities.”

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ATTORNEY GENERAL ANDREA CAMPBELL and nearly two dozen of her peers sued the Trump administration and federal health care agencies Monday, alleging that they unlawfully moved to cut crucial federal dollars for research.

Twenty-two attorneys general, all Democrats, filed a complaint in federal court in Massachusetts seeking to block an abrupt cut in National Institutes of Health (NIH) funding that goes toward administrative and overhead costs associated with research projects.

The NIH announced Friday that it would limit the amount of money available for so-called indirect costs — which it defines as covering “facilities” and “administration” — at 15 percent of new grants. That change, agency officials said, would ensure taxpayer dollars are directed primarily toward research costs instead of related overhead.

It would represent a significant shift: according to the NIH, in fiscal year 2023, the agency spent about $26 billion on “direct costs for research” and $9 billion on “overhead through NIH’s indirect cost rate.”

The policy was set to take effect Monday, the first business day after officials announced it.

Opponents argued that the sudden change runs afoul of a federal law known as the Administrative Procedure Act and could lead to layoffs, trial suspensions and laboratory closures.

“High-level research requires funds not just for the costs that can be directly attributed to the specific work of a particular project, but also the indirect costs that support multiple projects. These costs are broken up into ‘facilities’ and ‘administration’ costs,” plaintiffs wrote in their lawsuit. “For example, in order to conduct research, a university needs buildings, and needs to maintain those buildings and supply them with heat and electricity. A university also needs the infrastructure necessary to comply with legal, regulatory, and reporting requirements. These facilities costs cannot be attributed to any particular research project, but are still necessary for any research to occur.”

The attorneys general argued that research institutions negotiate indirect cost rates with the federal government, then execute agreements that apply to “all of that institution’s federal grants.”

They noted that President Donald Trump during his first term sought to reduce the indirect cost rate for research institutions to 10 percent, but that Congress stepped in to block the change.

“In 2018, Congress enacted an appropriations rider prohibiting HHS or NIH from spending appropriated funds ‘to develop or implement a modified approach to’ the reimbursement of ‘indirect costs’ and ‘deviations from negotiated rates,'” plaintiffs wrote. “That rider has remained in effect through every appropriations law governing HHS to this day.”

Campbell’s office warned that the shift could have massive impacts on Massachusetts, which is home to many research institutions and sizable pharmaceutical and biomedical industries.

In fiscal year 2024, NIH provided $3.46 billion to 219 Massachusetts organizations, according to Campbell’s office.

“Massachusetts is the medical research capital of the country. We are the proud home of nation-leading universities and research institutions that save lives, create jobs, and help secure a better future,” Campbell said in a statement. “We will not allow the Trump Administration to unlawfully undermine our economy, hamstring our competitiveness, or play politics with our public health.”

Explaining the new policy, NIH officials said many private foundations that fund research have lower tolerances for the share of funds that go toward overhead than do federal grants. Some organizations, they said, charge indirect rates of up to 60 percent from the NIH.

NIH leaders said the agency is “obligated to carefully steward grant awards to ensure taxpayer dollars are used in ways that benefit the American people and improve their quality of life.”

“The United States should have the best medical research in the world. It is accordingly vital to ensure that as many funds as possible go towards direct scientific research costs rather than administrative overhead,” NIH leaders wrote in a memo announcing the new limit.

The indirect cost rate cap and the ensuing lawsuit represent the latest chapter in Trump’s sweeping efforts to realign federal spending with his political priorities.

A federal judge previously blocked the administration’s proposed grant funding freeze. On Monday, the same judge said the administration has been violating his order to resume the spending, according to POLITICO.

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GOV. MAURA HEALEY intends to run for reelection in 2026, she said Friday.

“When Kim and I started, we laid out in our inaugural address things that we wanted to do. We wanted to get after housing, and we wanted to get after transportation, we wanted to cut taxes, we wanted to make investments in education,” Healey said on GBH Radio on Friday. “And I feel like we’ve done all those things, and there’s a heck of a lot more to do. And so I plan to run for reelection, because there’s a lot more to do.”

The Democrat was the first woman and first openly gay candidate elected governor of Massachusetts, and is halfway through her term in office. In her first two years, she has signed major laws related to incentivizing housing development, expanding clean energy, further regulating hospitals and the pharmaceutical industry, and making tax cuts.

Her administration has also been burdened with the handling of a number of crises, among them: the growing number of homeless families putting logistical and financial strains on the state’s emergency shelters, and a for-profit hospital system that collapsed last year, shuttering two hospitals. 

“I’m really proud of the record so far,” Healey said Friday. 

She later added, “I love my job, I feel incredibly privileged to be in this position, and I’d love to have the opportunity to continue to work for the great people of this state.” 

Healey has shown a keen interest in national politics, but there are no seats opening on the federal level in the near future. Democrat US Sen. Ed Markey said he plans to run for reelection in 2026. President Donald Trump’s election also closed a door for any Democrat in state office in Massachusetts who may have looked to join a Kamala Harris administration. 

Several Republicans are reportedly eyeing runs for the corner office as well. 

Former housing and economic development secretary Mike Kennealy is “seriously considering” a gubernatorial campaign, the Boston Herald reported last month, and Sen. Peter Durant told WBUR that he’ll decide this spring whether he’ll also make a bid. 

Kennealy was a cabinet secretary under former Gov. Charlie Baker, and now serves as senior advisor and chief strategy officer at the Boys & Girls Clubs of Boston. Durant won a recent special election to the Senate after spending years in the House, and has become one of the most vocal opponents among electeds of the administrations’ family shelter policy.

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AFTER THEIR BRAIN injury treatment legislation cleared one committee but then fizzled out last session, Sen. Paul Feeney and Rep. Kimberly Ferguson urged survivors Tuesday to share personal stories with lawmakers to help get the policy over the finish line in the new session.

The advocacy push came as the leader of the Massachusetts Association of Health Plans (MAHP) voiced her opposition to the insurance mandate, which she said would raise costs for consumers and small businesses. The proposed benefit also leaves a major coverage gap for Bay Staters on certain insurance plans, CEO Lora Pellegrini pointed out.

At a Brain Injury Association of Massachusetts (BIA-MA) event, Feeney recalled the good news he shared with advocates last year: The bills he sponsored with Ferguson requiring commercial insurers to cover cognitive rehabilitation therapy to treat brain injuries received a favorable report from the Financial Services Committee, which the Foxborough Democrat co-chaired.

While the Health Care Financing Committee later sent the bills to study, Feeney and Ferguson said they’re optimistic about the fate of their refiled proposals (SD 1890 / HD 866). Massachusetts may be a leader in health care, but “if it’s not affordable, it’s not accessible,” Feeney said.

“I want to urge you to have the optimism that I have, that as we start here today at the beginning of the session, we will not only get that bill out again and move it forward, but we will get it over the finish line this year. And I don’t say that lightly,” Feeney told advocates before they headed to meetings with lawmakers.

He added, “I promise you all that nothing motivates us and moves policy like your personal stories, like the stories of courage and persistence, the stories that turn pain into purpose.”

Insurance coverage would extend to people with an acquired brain injury (ABI), such as a traumatic brain injury, tumor, stroke and aneurysm. 

Pellegrini warned the proposals would add to seven new coverage mandates from last session, which she said will raise premium costs by $750 million over the next five years.

“In Massachusetts, those costs are borne primarily by small businesses and individuals who make up less than 40 percent of the employer-sponsored market,” Pellegrini said. “Self-insured plans, which comprise over 60 percent of the commercial market, are not required to add this mandate or others as part of a benefits package. “

Lawmakers and supporters emphasized their advocacy builds on a narrower success story from a 2021 health care law, which required commercial health insurance plans, the Group Insurance Commission and MassHealth to cover cognitive rehabilitation for COVID-19 patients.

More than 72,000 Bay Staters each year sustain a traumatic brain injury, which can cause impaired thinking, memory, movement, sensation and emotional functioning, according to BIA-MA. Only 12% of affected individuals receive inpatient rehab, and the legislation would help more Bay Staters access treatment with the aim of living more independently, the association says.

A former speech language pathologist, Ferguson said cognitive rehab therapy allows patients to retrain their brains, including by working on word retrieval and comprehension. 

Aside from questions about how much the policy would cost, Ferguson said she’s heard “very, very little opposition.” A 2016 analysis from the Center for Health Insurance and Analysis (CHIA) found the coverage mandate would raise monthly insurance premiums between 1 cent and 19 cents.

“It’s several years old, so we’ve been told maybe we need to go back to CHIA again and say, can you update those numbers for us? But I mean, no one really has an argument against helping ABI survivors improve their skills and become more functional in their day-to-day lives,” Ferguson said. “I’ve said it year after year: This is one of the most important bills that we can pass to change lives for people with ABI, their families and their caregivers.”

Demanding that lawmakers not raise costs for small business, Pellegrini said the Legislature should impose a “moratorium on new health care spending.”

“Without such action, continued coverage expansions and cost-sharing eliminations will only contribute to our affordability crisis,” Pellegrini said.

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