House move to save local hospitals sets up potential health care overhaul from Beacon Hill

When Ron Mariano rose from majority leader to Speaker of the House in January, those who had followed the Quincy representative's time in office knew he would exercise his new authority on at least one well-known priority: saving community hospitals.

At the end of his first year as Speaker, Mariano's looking to do just that, setting the playing field for even more extensive changes to the state's health care system in the new year. The House is set to debate and pass a bill Wednesday that would toughen state health care watchdogs and fortify obstacles faced by hospital chains trying to expand with facilities in areas that are already serviced by struggling local hospitals.

"We're looking to make some legal changes that strengthen [community hospitals'] position in the health care market," Mariano told GBH News when he announced his priority bill, seeking to make sure independent hospitals like Lawrence General, Brockton Hospital and Berkshire Medical Center survive in the face of increased competition from the likes of Mass General Brigham and Steward Health Care.

Mariano's bill is one portion of what could be a major health care overhaul from Beacon Hill: he’s offering up his longtime health care priority at the same time the Senate seeks a final push on major changes to the way the state handles mental and behavioral health services. A bicameral bargain could be in the works over the lengthy holiday break before lawmakers return for the second half of their two-year session in January.

Senate President Karen Spilka has made greater access to mental health care her own top priority this session, sending a bill that would mandate insurance coverage for annual mental health screenings to the House earlier this month.

Mariano's community hospital bill would have state health care cost overseers at the Health Policy Commission weigh in on the effect provider expansions would have on the market, including on completing hospital providers. In effect, when a major chain attempts to build a new facility that would require additional licensing, the state could block expansion plans that threaten community hospitals.

Major legislation given the blessing of House leadership rarely faces more than a handful of dissenting votes, and even fewer when it's the Speaker's known paramount bill.