12/21/2024 Saturday Scoop: How public records law could've prevented Steward disaster

Happy Saturday,

With the end of the 193rd session looming and the 194th session coming in hard right behind, all eyes are on the raucous intra-chamber race for leadership of…. the 24-person State House Republican caucus!

State Rep Marc. Lombardo of Billerica announced Wednesday that he plans to challenge long-standing Minority Leader Brad Jones for the position of top conservative. In his statement, he took aim at the fact that even Republicans are susceptible to the incentive structure employed by the all-powerful House Speaker, arguing for an end to “taking crumbs off the table in exchange for parking spots and stipends.”

Even if Minority Leader Brad Jones triumphs again, it’s an interesting example about what can happen when control over leadership positions is not absolute. And about what testimony it can prompt from caucus members: one Republican seized the opportunity to describe Jones as “a swamp creature at best.” !

Friend, I would pay. money. to get Democratic caucus members’ descriptions of Speaker Mariano when (some day) the gloves come off. But for progressives hoping for a similar bold challenge to leadership in the Democratic caucus, we’ll be left wanting. We don’t have intra-party democracy: we have a line of succession.

---

State House Scoop

Amidst state inaction, private equity continues to plow through our healthcare system

This week saw several landmark revelations about the continued influence of private equity in our healthcare system–and casting doubt on the ability or willingness of state leaders to regulate them.

Earlier this year, the dramatic financial implosion of the Steward healthcare system brought attention to the dangers posed by combining healthcare services with profit motive. Steward, a hospital system originally founded in Massachusetts, was the largest for-profit hospital chain in the country when it filed for bankruptcy, including 8 hospitals in Massachusetts. The state had to arrange frantically for 6 of these hospitals to be sold, while two were closed, leaving outraged communities without healthcare.

When Steward’s financial situation and its disastrous consequences were first made public, state and national leaders were quick to condemn Steward CEO Ralph de la Torre and Steward’s executive team for corporate greed, mismanagement, and neglect. However, the Globe’s Spotlight team released a damning report this week that accuses state leaders – including Governor Maura Healey and former Governor Charlie Baker – of enabling Steward’s crooked operating tactics and perpetuating harm with insufficient regulation, all while raking in tens of thousands of dollars in donations from Steward employees.

If you have a Globe subscription, I encourage you to read the report yourself: “Softened reports. Lax oversight. How state officials enabled Steward’s rise and fall.” It is a riotous account of our state officials acting to protect the interests of a private corporation– often at the cost of patient well-being. I’ll summarize some of the highlights (or lowlights):

While Steward was in dire financial straits and “seeking millions in bailout money from the Healey administration,” MA’s Secretary of Health and Human Services made a call to Ralph de la Torre on behalf of Healey’s office to request that Steward rehire a nurse who had been fired after a patient death – and who also happened to be the wife of a top state health official in Healey’s administration. The nurse was promptly rehired.
As Attorney General, Healey’s office reworked a 2015 report on Steward to “downplay its perilous financial condition” and bury a $30.9 million payout Steward had made to its top executives in the midst of financial crisis, to the dismay of a lead author of the report.
Steward broke Massachusetts law intended to protect patients from harmful hospital closures at least 8 times, including during the COVID-19 pandemic, when essential hospital services were discontinued without proper notice. The state neglected to intervene and Steward faced no consequences.
Steward “aggressively pushed its employees to donate” to politicians in state and out-of-state, even bundling employee donations to “give credit to the boss” in negotiationswith state officials.

Since the Spotlight report was released Saturday, Gov. Healey has responded by defending her record and placing the blame squarely on CEO de la Torre. However, her words ring hollow in the light of the Globe’s revelations. While she dismisses some of the report as “insinuation” and “unfounded,” she did not explicitly deny any of the report’s claims. This underscores the importance of strong local journalism to hold our elected officials accountable.

A report of this magnitude, as assembled by the Spotlight team, relies on documents and communication dating back to 2011 to bring the inaction on the part of our state leaders to light. If the evidence of Steward’s failings dates back over a decade, why are we just learning about the magnitude of this crisis now?

Part of the answer comes from a unique feature of Massachusetts that shields elected officials from scrutiny and perpetuates such crises: we are the only state in the country where all three branches of our government claim an exemption from public records law. Therefore, all of these communications between state officials were hidden even from the inquisitive eye of investigative journalists, likely until they were subject to subpeona because of recent court cases.

Therefore, it is not an exaggeration to say that our unique lack of transparency in Massachusetts has a human cost. Lives could have been saved if Steward was properly held accountable for their neglect by state regulators.

In January, our legislators will be granted the choice to subject the executive branch to public records law through passage of our Sunlight Act. Although it will not make up for the harm caused by inadequate oversight, we can ensure that the public has a role in holding our elected officials accountable to, in their turn, hold bad corporate actors like Steward accountable. Or, at the very least, allow the public to make informed decisions come election time about which regulators get the top job.

State house inaction stalls Steward response while private equity expands control

With only 10 days left in the year, things are also looking bleak for the state’s attempt at a legislative salve to the lax regulations that enabled the Steward healthcare crisis.

When the crisis first unfurled earlier this year, House leaders seized the opportunity to advance a billthat would make some long-overdue updates to laws governing oversight of the healthcare industry, including healthcare costs. It sought explicitly to increase transparency around private equity investment in healthcare companies, and boost fines for failures to disclose.

The Steward crisis prompted bold rhetoric from top leaders, including a declaration from powerful Senate Democrat Michael Rodrigues that legislators would “take for-profit, equity-based companies out of the health care system.” However, we’ve learned not to bet on swift action from the legislature. The Senate passed a different version of the hospital oversight bill in July and it has remained stuck in conference committee ever since. With the session coming to a close, it is unlikely that this issue will see new legislation this year.

This, too, has real consequences: while senators and representatives in conference committees hem and haw over the possible effects these regulations might have on the all-powerful MA health industry, regulators just approved the sale of one of Steward’s last remaining assets– their doctor’s group to another private equity company.

On May 6th, on the heels of the Steward crisis, Speaker Mariano was quoted saying: “it is the Legislature’s responsibility to ensure that what happened with Steward Health Care never happens again.” We couldn’t agree more.

As for the current response from Speaker Mariano, I’m sure you can guess: crickets.

Let’s remember also that there’s a legislative solution that would rid Massachusetts of private influence in healthcare once and for all: Medicare for All. Single payer healthcare is broadly popular in Massachusetts: just this election cycle, it was on the ballot in 11 districts and won all of them, including two districts that Trump won. Despite legislator’s flashy declarations of getting private interests out of healthcare, this bill was once again sent to study without a vote.

Also in the news this week

Syd's Sprinkles: Act on Mass’s Requests for Trump’s First 100 Days

With Donald Trump's recent reelection, local action to protect progressive values and the safety of our communities is more important than ever. Without a competent or representative federal government that operates in ways that actually benefit the average American rather than members of the elite, vulnerable and marginalized groups will increasingly face the brunt of the effects of harmful legislation and suffer from the lack of proactive, protective legislation.

The uncertain and terrifying times that we are quickly heading into are only exacerbated by the current state of the House and Senate at the Federal Government. The national government now has the ability to pass legislation that has the potential to affect all Americans negatively and the conservative majority in the Supreme Court means that even laws that seem to cover basic rights are at stake of being torn down. Without a democratic caucus large enough to stop MAGA republicans, the US Congress is threatening legislation that will stifle the rights and protections that are currently in place for U.S. residents – especially for the country’s most marginalized groups.

With this being said, it is not time for us to shut down and hide as we enter another Trump presidency. Trump now has a better understanding of the federal government and is looking to weaponize it against its own citizens.

It is time for us to stand up and push for Massachusetts to enact protections with more vigor than ever.

READ THE BLOG POST >>

---

Take Action

Call on state leaders to take action before Trump 2.0!

Lend your voice to the movement of progressives calling on state leaders to take immediate, proactive steps to protect MA residents– especially our most vulnerable neighbors– from the policies set to emerge at the federal level come January 20.

Click here to personalize an email to Governor Healey:

TELL GOV. HEALEY: TAKE ACTION NOW>>

Click here to personalize an email to legislative leaders:

TELL STATE HOUSE LEADERS: IT CAN'T WAIT>>

---

That's all for this year, folks! Wishing you all a restful end of the year and I'll see you back here in 2025 to pick right back up where we left off.

In solidarity,

Scotia

Scotia Hille (she/her)

Executive Director, Act on Mass