After keeping onlookers guessing for weeks about the contours of its plan, the House made clear with a resounding vote Thursday that its leaders, too, want to force the Massachusetts health care industry to dedicate significantly more resources to a primary care sector in crisis.

Representatives embraced a sweeping bill that would more than double the share of health care spending that goes toward the front lines of care, plus erect new limitations around how insurers can use artificial intelligence and require more money from drug rebates to flow to patients.

Coming six weeks after a similar bill cleared the Senate, the House’s unanimous vote signals that lawmakers are ready to fashion a far-reaching bill that could fundamentally reshape the state’s health care landscape.

Wayne Altman, a family medicine physician in Arlington who has long been urging policymakers to improve support for primary care, said a final accord could become the most impactful health care legislation in Massachusetts since the reform package known as “Romneycare” was enacted two decades ago.

“Both of these bills are outstanding bills, and in and of themselves would be historic, national stories,” Altman said of the House and Senate proposals. “This primary care bill that will pass in 2026 will be a national model for primary care legislation all over the country in the same way Romneycare was for Obamacare.”

The hard work is not done. While both branches are in alignment on some of the biggest general ideas, legislative negotiators will now need to hash out a host of specific details and find common ground on areas where the House and Senate diverged. They have the next five months to do so before the legislative term ends.

Doctors, patients, and advocates have been warning for years that the primary care system is teetering in a precarious position. Physicians are leaving the field more quickly than new practitioners are joining, and securing an appointment has become increasingly difficult. One survey published in June 2025 found that a patient in the Boston area needed to wait an average of 69 days to book a physical with a new provider, the longest among 15 cities studied.

More Context

• Primary care spending proposal sets the stage for legislative action in 2026 (December 2025)
• Senate ready to force more money toward primary care — and away from specialists (June 2026)