LAST TWO WEEKS IN REVIEW

The government shutdown

The government shutdown: To answer your questions about the shutdown, I’ve added a resource page with information on what a government shutdown means, how it affects Bay Staters, and other frequently asked questions (FAQs). I’ve also been setting the record straight in interviews. The Republicans are trying to pin this dispute on undocumented immigrants. That’s because they don’t want to talk about the primary issue under debate: health care. MAGA’s Medicaid cuts raise the cost of health care; state Medicaid agencies and community health centers need relief.

My op-ed: how Massachusetts can lead on lowering health care costs

My op-ed: how Massachusetts can lead on lowering health care costs: Necessity is the mother of invention. MAGA is cutting Medicaid, but the upcoming waiver process gives Massachusetts the opportunity to invent a stronger version of MassHealth that lowers costs and improves access. It's risky, but the status quo of spiraling costs and deepening cuts is riskier. Read my Boston Globe op-ed on a deal that would turn the tables on MAGA's Medicaid policy. 

Here is a segment of my op-ed: 

…MassHealth, the state’s Medicaid program, is experiencing what hospitals would call code gray — an assault on the grounds. President Trump’s One Big Beautiful Bill slashes at least $2 billion annually from MassHealth, which provides medical insurance for children and the poor. It also adds onerous requirements for the agency to administer. State and federal officials must come together to protect MassHealth. Better yet, we should make necessity the mother of invention.

Here’s how we can do that.

Every five years, MassHealth negotiates with federal Medicaid officials for what’s known as a Section 1115 Demonstration. It’s a waiver that gives MassHealth flexibility in how it delivers and pays for health care in our state. The current waiver is set to expire at the end of 2027. Negotiations for the next waiver will begin when MassHealth submits its proposal to the secretary of health and human services, Robert F. Kennedy Jr., at the end of 2026.

MassHealth’s new proposal should offer a radical deal: 1. MassHealth accepts an inflation-protected grant from Washington. 2. In return, MassHealth gets to make its own decisions about how to reduce costs and increase quality. And 3. If MassHealth does reduce costs, it gets a share of those cost savings from the federal government.

…Freed from federal rules and bureaucracy, MassHealth could braid together benefits. Medicaid, welfare, food stamps, home-heating relief, and rental assistance all put federal dollars in reach of the same population. MassHealth could streamline eligibility and enrollment. It could laser focus on impact for children. It already insures 4 in 10 children in Massachusetts, so MassHealth is well-positioned to quarterback the full playbook of services that improve children’s health and wellness.

…MassHealth is already making strides in paying for value instead of volume. It is two years into a program in which it pays the state’s 17 accountable care organizations (ACOs) for patients’ total cost of care. ACOs are organizations led by doctors and other health care providers, and they are financially accountable for the quality and cost of the care. This experiment is meant to drive a shift away from fee-for-service medicine toward more investment in primary and preventive care, in particular.

…Massachusetts has always been at the cutting edge of health care. Democrats have always prioritized health care. Democrats in Massachusetts should offer a better plan than just someday taking back the House, Senate, and White House. We should negotiate this waiver as a demonstration. Massachusetts can show the nation a better way on health care — just as we did with the Affordable Care Act — that delivers quality primary, behavioral, and elder care, at lower cost.

Supporting Community Health Centers: I met with the Mass League of Community Health Centers to discuss funding and Medicaid. For years, community health centers have had their federal funding cut in real terms, despite delivering primary & preventative care highly effectively. For 1% of all US health spending, they care for 10% of patients. If the federal government tripled funding (through Section 330 grants) to $18 billion per year, health centers could reach closer to one-third of Americans, particularly children, with medical services like check-ups, screening, diagnostics, optometry & audiology, and pharmacy. 

For reference, $18 billion a year is less than what health insurance corporations currently overcharge Medicare Advantage annually through fraudulent billing practices known as 'upcoding'. Think about that: just by redirecting the waste, fraud, and abuse by health insurance corporations in one federal insurance program, Congress could help triple the reach of primary care, which will improve health, lower premiums, and reduce wait times.

Bipartisan progress on Rx drug pricing

Advancing biosimilars: Americans could save up to $100 billion with more competition to biologic pharmaceuticals. Biologics are medications that come from living organisms, like proteins and genes. Examples include vaccines, plasma transfusions, and gene therapies to treat rare genetic conditions.

Biologics are expensive to research, develop, and manufacture, so first-to-market inventors get a period of exclusivity to return their investment. But after that period expires, competition is critical to drive down the price. These competitors are called biosimilars. There is ~$100 billion of invoices spent today on biologics that could have a biosimilar competitor, but do not. I support pro-competition reforms to Medicare payment policy, rebates, and FDA switching studies to get biosimilars to market faster and easier.

To achieve these ends, I cosponsored the bipartisan Biosimilar Red Tape Elimination Act, which would improve patient access to lower-cost prescription medications and increase competition in the biological drug market by automatically deeming “biosimilar” drugs as interchangeable with their name-brand counterparts upon approval by the Food and Drug Administration (FDA).

I was pleased to receive an award from the Biosimilars Forum for my efforts to support competition and lower costs for patients who depend on these biologics. 

Pharmacists fight back: Pharmacists United for Truth and Transparency is a grassroots organization of community pharmacists who are fighting back against the health insurance corporations that are driving them out of business and raising co-pays for their patients. I spoke to the pharmacists about my bipartisan legislation, Pharmacists Fight Back, which ends the worst abuses by the pharmacy benefit managers (drug-pricing middlemen owned by the health insurance corporations). This effort is not just about a fairer and more rational drug-pricing system; it's also about building an economy that works for small businesses, not middlemen and monopolists.

Safe sunscreen standards: In the United States, skin cancer affects over 3 million people annually, claiming more than two lives every hour. I cosponsored the bipartisan Supporting Accessible, Flexible, and Effective (SAFE) Sunscreen Standards Act that would streamline the Food and Drug Administration’s (FDA) review process for new non-prescription sunscreen ingredients. The goal is to get Americans the same safe and effective sunscreens available in other countries. The bill would also incorporate non-animal testing alternatives for evaluating sunscreen ingredients.

Standing up for science & young scientists

Science is good for democracy, not just innovation: Stand Up For Science is mobilizing pro-science activists to expand funding for R&D, end censorship and political interference in science, and promote equal opportunity in STEM education and clinical trials participation. I have spoken at their rallies and met in the Capitol with the Founder and Executive Director, Colette Delawalla. 

Together, we compared notes and strategized on how her work with activists and mine on the committee of jurisdiction over RFK Jr., can mutually support one another. Science is not just the driver of innovation and economic growth — it's also vital to democracy. The truth-seeking inherent in the scientific method is foundational to democratic discourse.

Protecting Free Vaccines Act: One of RFK Jr.’s most egregious moves was firing the entire Advisory Committee on Immunization Practices (ACIP) and replacing it with anti-vaccine activists. In response, I cosponsored the Protecting Free Vaccines Act to ensure that health insurance plans continue to cover all of the ACIP-approved vaccines previously recommended. The coverage should be comprehensive and without cost-sharing. This legislation is about making sure families don’t lose access to the vaccines that have saved 150 million children’s lives over the last half century, no matter how much political gamesmanship is happening in Washington.

Launching the Biotech Caucus: At a moment when RFK Jr. is gutting vaccine guidance, it’s critical to build a bipartisan bulwark for science in the House. I’m a vice chair of the Biotech Caucus, where Democrats and Republicans are working together on 50+ policies to advance biotechnology in America — not just for medicines, but for food, fuel, and materials too.

Supporting our next-gen scientists: Young scientists are hit extra hard by research freezes and visa chaos. I spoke to a big group of them at a virtual summit organized by Nucleate, a student-led organization that represents the largest global community of bio-innovators. My theme was positive disruption: as we rebuild the scientific enterprise following RFK Jr., we should think from first principles about talent & money for science:

• less bureaucracy, more replication studies, and greater willingness to experiment with different ways of funding people & projects; 

• new pathways to bench science & biotech entrepreneurship beyond the PhD and post-doc route; and

• technology to automate and augment research and development to do more experiments, faster.
  

Geothermal & hydropower in Massachusetts

Clean energy connection to Canada: Canada is a close ally; New Englanders in particular have a rich 400-year history with our northern partner. Yet the president's assault on our alliance, including tariffs and threats to invade, and his arbitrary & capricious raids on foreign workers and investors, have rattled our Canadian friends.

This does not just impact trade, tourism, and national security. It also affects energy. Hydro-Quebec is the Canadian corporation that manages and exports hydropower from Canada. Next spring, Massachusetts will benefit from a new transmission line from Quebec, running through Maine, that will transmit enough clean power for a million homes in the Bay State. The partnership could expand. The demand profiles in Quebec and Massachusetts are different; the demand peaks do not overlap, so trading electricity is efficient. In the future, Massachusetts could send offshore wind power to Quebec during non-peak hours for us, and peak hours for them. Everyone pays less.

I met with Hydro-Quebec leaders to assure them of Bay Staters' commitment to our alliance with Canada and to encourage continued partnership in all sectors, including energy infrastructure.

New Franklin trade school powered by geothermal: Tri-County Regional Vocational Technical High School in Franklin had its topping off ceremony to celebrate the last steel beam installed for its construction. After speaking, I toured the geothermal installation, which takes advantage of tax credits passed by Congress's clean energy legislation from the Biden Administration. I had encouraged Tri-County to take advantage of these tax credits and am thrilled to now see a geothermal project that will provide heating & cooling year-round for the school at almost no ongoing cost. The geothermal wells, which are underneath playing fields, go hundreds of feet deep and will be powered by solar panels; the ongoing cost of maintenance and operation for this heating & cooling system will be near zero.

Guardrails for children and AI chatbots: Facebook's internal documents said it was appropriate for chatbots to have “sensual” conversations with 12-year-olds. Parents disagree, and we’re going to protect our children. That is why I co-led the bipartisan AI Warnings And Resources for Education (AWARE) Act, which directs the Federal Trade Commission (FTC), in consultation with other federal agencies like the Consumer Product Safety Commission, to create public resources for parents, educators, and minors on how to safely and responsibly engage with AI chatbots. These resources will provide guidance on identifying unsafe bots, understanding privacy and data collection, and best practices for family oversight.

Do social media platforms have a responsibility to put guardrails around children’s access to AI chatbots?

Aligning America & the Arab League to pressure for peace in Gaza: Hamas does not fear another assault — it fears an alternative. America must bring together the Arab League and Israel to return the hostages, end the war, and govern Gaza without Hamas. I led 29 House Democrats in a letter to Secretary of State Marco Rubio urging him to work with the Arab League to put real pressure on Hamas to end its war against Israel.

On July 29, 2025, for the first time, all 22 Arab League member states–including Saudi Arabia, Qatar, Egypt, Jordan, and Turkey–supported a joint declaration condemning Hamas’s October 7, 2023 attack and calling on the terrorist group to unconditionally surrender by freeing all hostages, disarming, and relinquishing control of Gaza. In our letter, we asked Secretary Rubio to work closely with Israel and move quickly to convene key regional and international partners to broker a coordinated agreement that achieves three vital objectives:

1. the immediate and unconditional release of all Israeli hostages held by Hamas;

2. the removal of Hamas from political and military control of Gaza; and

3. a responsible de-escalation of the conflict to protect civilians and create space for reconstruction, governance reform, and peacebuilding.

While the President’s current 20-point peace plan includes some of these objectives, it's more of a concept than a plan. Particularly challenging is #16, which, while rightly acknowledging that Israel cannot occupy or annex Gaza, relies on vague “standards, milestones, and timeframes” set by Netanyahu to determine when Israel will withdraw. The framework is reasonable, but America and the Arab League will need to be assertively engaged to stand up better governance in Gaza, release the hostages, and end the war.

Question: Dear Congressman, I hope you can address what the Democrats in D.C. plan to do when faced with forcing a possible shutdown of the government in October. I understand, but I did not necessarily agree with why we didn’t shut down the first time around. However, at this point, the theory that the courts could restrain Trump's demons has proven non-existent. Do the Democrats have a plan, a set of demands, that under no circumstances you, our elected representatives in DC, will not back down from if not met by the Republicans? Please tell us that all this infighting and turmoil among D.C. Democrats has resulted in some cohesive message that you plan to roll out and stand strong against to prove to us and to the world that TRUE American Democracy is not dead?

 - Marisol, Franklin

Answer: Several weeks ago, I led other congressional Democrats in a statement advising the Speaker what the starting points of negotiation for funding the government should be. I wanted to avoid a shutdown without offering an empty vote to fund a lawless administration. These starting points centered on health care, public safety, and corruption. In particular: shielding Medicaid from the worst of the cuts that will raise health care costs for Americans, re-funding the COPS grants that Republicans have cut, and moving bills that address conflicts of interest and self-dealing by elected officials. Each of these issues has super-majority support from Americans. They continue to be my focal points.

You can submit a question for a future newsletter here. Please note that casework inquiries for federal agencies must be submitted to my website here. My casework team will respond to these in a timely manner. 

Onwards,

Jake