The Barnstable County Assembly of Delegates voted on Nov. 19 to endorse pending Massachusetts single-payer legislation through Resolution 2025-13, following a unanimous technical amendment to add specified state committee chairs and staff and a subsequent roll-call vote on the resolution itself.

Delegate O'Malley, who introduced the measure from the standing Health and Human Services Committee, framed the resolution as both a human-rights and fiscal issue. He said the county completed a spreadsheet analysis showing the county would "stand to save $2,500,000 every year" on employee health-insurance costs under the version of the state legislation he described. O'Malley added: "When I use the expression care delayed is care denied, that's what I'm talking about," citing personal clinical experience and local stories.

Delegates discussed practical implications including the proposed payroll-tax funding structure, the potential effect on private insurers, and the transition for municipal employees. Some delegates voiced support on principle while others sought more detail about fiscal mechanics and federal coordination. Delegate Frederickson abstained on the final vote; Delegate Killian voted no. Clerk Fletcher recorded the final tally as 13 delegates in favor, one no and one abstention; the assembly agreed to send the endorsement and the names of the added recipients to state legislators and the joint committee on health-care finance.

Before the final vote the assembly approved a technical amendment proposed by O'Malley to add Senator Cindy Friedman, Representative John Long and other named state officials and the statewide MASCARE organization to the list of recipients for the county's endorsement; that amendment passed unanimously.

The assembly's endorsement is a formal expression of support to state lawmakers and committee leaders; the resolution does not alter county law or budgets and does not itself create a payroll or funding mechanism. Assembly members said the endorsement is intended to add regional weight to the broader statewide discussion.