BOSTON – Holding up a rubber band ball, Sen. Julian Cyr compared the dense, multilayered orb to the American health care system.

"I would be the first to want to – I don't have a knife on me, I should have a knife on me – to take this and chop it and split it in half and move to a single-payer system tomorrow," Cyr said. "But I think we need to be honest about how complicated the system we've created is, and provide a roadmap and pathway for us to really meaningfully look at how we would do this."

The Truro Democrat spoke at a lobby day held Wednesday by Mass-Care, an organization that advocates for a single-payer health care system run by the state government, sometimes described as "Medicare for all."

As backers gear up for the next phase of an effort they've been pursuing for decades, they're touting progress in the Senate last session and the energy newly elected lawmakers are bringing to the issue.

Sen. Jamie Eldridge, an Acton Democrat who has been filing single-payer bills on Beacon Hill for years, said adopting such a system would eliminate "gaps" in the current health care landscape that can make it difficult to get care.

"For those that are advocating already early in this session on making sure that reproductive rights is guaranteed for every single Massachusetts resident, who are concerned about addressing the opioid crisis, who are concerned about the gaps in mental health services across Massachusetts or are just outraged about the copays and deductibles they're having to pay for very basic medical services, what we know -- and studies should back this up in every possible way -- that Medicare for all is the only solution to addressing all those problems we have here in Massachusetts," Eldridge said.

Cosponsors of Eldridge's bill (SD 2062), as of Thursday afternoon, were Sens. Jo Comerford, Rebecca Rausch and Jason Lewis, and Reps. Lindsay Sabadosa, Denise Garlick, Jack Lewis, Carmine Gentile, Mike Connolly, Natalie Blais and Daniel Carey.

'Inside-outside effort'

Comerford, Rausch, Sabadosa, Blais and Carey are among the first-term lawmakers who have voiced support for single-payer, as are Reps. Tami Gouveia, Tram Nguyen and Mindy Domb, who all attended the lobby day.

Garlick, of Needham, and Sabadosa, of Northampton, have each filed "Medicare for all" bills in the House.

"I am delighted to fight this fight in the State House, but I'm even happier that you are all here today because this is going to take an inside-outside effort," Sabadosa told lobby day participants. "We are going to need organizing in every single city and town in Massachusetts. We are going to need to provide education. We are going to need to explain what this is, and that is not easy, so this is not a short-term game, but we are here today launching the long-term strategy about how we get there."

Garlick said single-payer legislation was first brought forward in Massachusetts in 1986. The current movement, she said, is "built on the shoulders of giants."

The Eldridge and Sabadosa bills, according to Mass-Care, would replace employer and employee premium payments to private insurers with a tax on payroll – 7.5 percent for employers and 2.5 percent for employees – to finance the single-payer system.

In November 2017, as part of a broader health care bill that ultimately died in negotiations with the House and did not become law, the Senate voted 35-3 for language calling for current health spending to be measured against the estimated costs of providing health care to all residents through a single-payer system. If the projections proved less costly, state officials would have been tasked with developing a single-payer implementation plan for potential legislative action. A similar proposal in 2012 failed 15-22 in the Senate.

Cyr, the sponsor of the 2017 amendment, refiled the proposal this year as standalone legislation (SD 2172).

After the overwhelming Senate approval last session, Cyr said "we might be getting more" votes in favor this time around.

"This is an issue that advanced significantly," he said.

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