Massachusetts senators are ready to embrace a sea change in the state’s health landscape by forcing far greater focus and spending on primary care. In the process, they’re inviting a heavyweight political throwdown with influential hospital systems.

The Senate will vote next week on a bill that would reshape and reinvigorate the strained primary care system, more than doubling the amount of money that goes toward health care’s entry point and incentivizing more doctors to choose the field instead of other, higher-paying specialties.

It’s a long-gestating response to a problem that has been worsening for even longer. Most health experts agree that primary care in Massachusetts is in crisis, with patients routinely stuck waiting months for appointments and many members of the burned-out health care workforce heading for the exits.

But getting buy-in on a potential solution presents a challenge. The Senate’s proposal aims to significantly increase what insurers and providers spend on primary care without increasing the total amount of spending, meaning that some combination of other sectors like pharmaceuticals and specialty care would essentially lose money. Plus, the House has not given any indication that it’s also ready to tackle primary care overhauls in a quickly closing window this term.

“We absolutely expect that we’ll get pushback from hospital systems and specialty care. We will. We definitely will,” Sen. Cindy Friedman, the architect of the Senate’s bill, told CommonWealth Beacon. “This is a big change. If it happens, it’s a definite shift in how we’re paying.”

Policymakers regularly praise primary care as the linchpin of the system. It’s often designed to be the front door to medical care, allows physicians to develop long-term relationships with patients, and can help control costs by eliminating the need for pricier specialty or emergency care down the line.

Yet primary care’s cracks are increasingly turning into chasms. A new Center for Health Information and Analysis survey published Thursday found that 43 percent of Bay Staters had difficulty obtaining health care in 2025, up 10 percentage points from four years earlier. A report published last year found patients in Boston faced the longest average wait — 69 days — among residents in 15 cities when booking a physical with a new provider.

Investment in the sector is paltry, too. In 2023, only 7 percent of health care spending by commercial insurers went to primary care; a year later, that share fell to 6.6 percent.