Heavy health care focus in Senate spending plan
Priorities similar to House but with different funding levels
By 
LEADERS IN THE Massachusetts Senate on Wednesday laid out a plan for spending $3.66 billion, taken from a combination of federal money from the American Rescue Plan Act and some surplus money left over from last year’s budget.
The bottom line of the bill is very similar to the spending bill already passed by the House, where lawmakers proposed spending $3.65 billion, then increased that to $3.82 billion on the floor. Both bills would make large investments in health care, housing, economic development, and infrastructure. But there are some different priorities. For example, the Senate would spend more on health care and infrastructure, while the House would spend more on education.
“The bills are very, very similar,” said Senate Ways and Means Chair Michael Rodrigues. “We really had the same priorities in the same buckets, just different sub-amounts in the buckets.”
The Senate bill would spend around $2.5 billion in ARPA money and $1.45 billion in surplus money. Similar to the House proposal, it would leave just under $2.5 billion in federal ARPA money to spend in future years.
Senate President Karen Spilka said in a statement that the Senate bill would rebuild resiliency in critical areas. “We need to address immediate and critical needs in mental health care access, food security, the struggles of small businesses and access to housing,” Spilka said. “We must also continue to build up and support our public health system, including by investing in our local boards of health.”
Experts have talked about the ARPA money as an opportunity to make transformational change, with a massive influx of one-time federal dollars. Rodrigues said some of the items proposed by the Senate on mental health, public health, and housing could be “game changers” in those areas.
On some of the biggest items, the two bodies are in agreement. The House and Senate agreed to direct $500 million toward premium pay for front line workers and $500 million to reimburse the unemployment insurance trust fund, and to institute tax relief for small business owners who would otherwise have to pay personal income taxes on COVID relief money.
But the Senate bill focuses more on health care spending. It would allocate $1.28 billion to health and human services, compared to $765 million envisioned by the House, with a particular focus on mental health and workforce development initiatives.
As CommonWealth previously reported, senators are proposing a $400 million investment in behavioral health care with a focus on workforce development, compared to $250 million in the House bill.
The Senate plan also includes $250.9 million to shore up local and regional public health infrastructure, compared to $150 million in the House bill. The COVID pandemic has highlighted the need for a more standardized public health response across the state, rather than the current system where each community has its own public health department with vastly different levels of resources.
Another $300 million would go toward workforce needs for providers of home and community-based health care. The Senate would provide $200 million for financially strained hospitals, which is less than the $250 million proposed by the House bill. Additional health-related dollars would go toward nursing homes, initiatives to bolster the human services workforce, and grants to prevent community violence.
The two bills would spend identical sums on housing – $600 million – but the Senate would spend more to incentivize the production of affordable rental housing, while the House would spend more on enhancing opportunities for homeownership.
The Senate would spend $450 million, $100 million more than the House, on environment and climate change. The biggest difference is in the $175 million the Senate would spend on water and sewer infrastructure, compared to $100 million in the House. Both Rodrigues and House Ways and Means Chair Aaron Michlewitz have said they hope Congress will pass an infrastructure bill which could steer billions of dollars of additional money to Massachusetts for capital investments, particularly related to climate change.
Both bills would create mechanisms for tracking spending and ensuring accountability, making sure money flows to poor and minority communities.