The Massachusetts Senate on a recorded vote passed An Act Strengthening Health Care Protections in the Commonwealth (Senate No. 2538), a bill that expands legal protections for providers and patients of reproductive and gender-affirming care and places new limits on certain health-data sharing.

The bill, ordered to a third reading and then passed to be engrossed after roll call (final recorded tally: 37 ayes, 3 nays), was sponsored and described on the floor by Senator Cindy F. Friedman. Friedman said the measure builds on the 2022 Shield Act and was drafted with input from the Attorney General’s office, the Department of Public Health, the ACLU of Massachusetts, Planned Parenthood, reproductive equity advocates and LGBTQ legal defenders.

Friedman and supporters told the Senate the bill has several components intended to shield Massachusetts providers and patients from out-of-state and federal investigations and private data queries:
- Limits on information sharing by insurers, electronic health record managers and other entities responding to out-of-state or federal investigation requests, and strengthened limitations on state agencies sharing such data.
- A state-level Emergency Medical Treatment and Active Labor Act (state EMTALA) clarifying that stabilizing care in an emergency can include abortion or care during active labor when needed to stabilize a patient.
- Protections that make personal health information about reproductive or gender-affirming care less accessible by public-record requests and limit inclusion of such prescriptions in the state Prescription Drug Monitoring Program (PDMP) unless necessary to protect public health.
- A new mechanism allowing providers to request pharmacies print a practice’s name instead of an individual clinician’s name on certain medication labels.
- Expanded license protections to additional provider categories (for example, certified professional midwives) and to attorneys, protecting professional licenses from disciplinary action solely for providing or facilitating care covered by the statute.
- Protections in Massachusetts courts against treating an out-of-state court’s adverse finding about gender-affirming care (for example, a finding of child abuse) as the sole basis for altering custody or visitation decisions.
- Protections against insurance discrimination by prohibiting insurers from raising premiums or otherwise penalizing nonprofit providers solely because they deliver reproductive or gender-affirming care.

Several amendments were considered and adopted during floor debate. Senator William N. Brownsberger offered an amendment (adopted) that excludes medications tied to reproductive and gender-affirming care from inclusion in the PDMP and requires the Department of Public Health to consult practitioners when determining the scope of exclusions. Senator Mark C. Montigny successfully pressed for provisions addressing health-related data disclosures and raised concerns about commercial data flows; his remarks led to a roll call and adoption of an amendment that added oversight and de-identification language in monitoring requests. Senator Rebecca L. Rausch offered and won an amendment clarifying that active labor is within the scope of the emergency-care protections.

Senator Julian Cyr spoke in support, emphasizing Massachusetts’ history of protecting LGBTQ and reproductive rights and noting prior measures dating from nondiscrimination laws through the 2022 Shield Act. Members across the chamber debated the scope of data protections, implementation mechanics, and the possible need for follow-up work to respond to federal rule changes affecting coverage for gender-affirming procedures.

On process, sponsor Friedman requested and the Senate agreed to recorded votes at several points; after the Ways and Means amendment and subsequent floor amendments were adopted, the Senate ordered the bill to a third reading and passed it to be engrossed.

The bill text references state-level implementations (for example, DPH guidance and PDMP exclusions) that will require agency rulemaking and consultation; senators noted that further work may be needed to address federal actions such as federal CMS rules and pending litigation that could affect coverage and enforcement.

With the Senate passage, S.2538 as amended will be engrossed in the Senate record. The transcript shows the final recorded vote on passage to be 37 in favor and 3 opposed.