“A lot depends on what happens in the House of Representatives,” where final results were still trickling in, she said. “If that were to go to the Republicans, I think there’s a real chance they would repeal the ACA.”
Pellegrini, who is also president of the Massachusetts Women’s Political Caucus, said she worried about health care costs, affordability, and especially women’s health issues under Trump.
Noting that Massachusetts has strong protections for the right to abortion, contraception, and in vitro fertilization, she said “those protections could be taken away at the federal level” if a Republican-led Congress passed bans.
Pellegrini also said she worried about the role anti-vaccine advocate Robert F. Kennedy Jr., who also opposed fluoride in the water supply, might play in the new administration, concerns also voiced by a slew of local biotech leaders last week. “His views on health care are very extreme and aren’t supported by science,” she said.
Steve Walsh, president and chief executive of the Massachusetts Health & Hospital Association, which represents more than 70 hospitals and health systems, said in a statement that “we recognize that this is a frightening time for our health care institutions and many of the most vulnerable in our communities.” Reproductive rights, access to health insurance, and the funding of major health care programs, he said, hang in the balance.
“If there are threats to patients’ basic rights, we will fight those challenges each and every time,” he said. “For every piece of misinformation, we will stand ready with the facts. And if there are attempts to divide our nation on matters of science, we are committed to being a unifying force for what is real.”
Steven Holtzman, the retired chief executive of Decibel Therapeutics and a former executive vice president at Cambridge-based Biogen, was most worried about a rollback of the ACA and a further erosion of reproductive health care for women, including access to abortion.
Although Trump has signaled that he doesn’t want to revisit one of his signature, unsuccessful, initiatives in his first term — repealing the ACA — Holtzman said Trump is “mercurial” and surrounded by ideologues who might seek to do that.
He said that Project 2025, the political road map published by the conservative Heritage Foundation and embraced by some Republicans, is committed to unraveling the ACA and rolling back Medicaid benefits. He feared “a large percentage of our citizenry returning to the pre-ACA days” when millions more Americans lacked health insurance and access to health care, he said.
Similarly, Holtzman was worried that reproductive health care, including access to abortions, would become harder for women to get. The US Supreme Court, with three conservative justices appointed by Trump, in 2022 overturned Roe v. Wade. That landmark ruling returned to the federal and state legislatures the power to regulate any aspect of abortion not protected by federal statutes.
Trump has distanced himself from some national abortion restrictions sought by conservatives and pledged in a presidential debate to veto a nationwide abortion ban if it got to his desk. However, Holtzman said he was afraid that a politicized judiciary and Justice Department might lead to court rulings that further erode the already narrowed protections of abortions in some states.
John Maraganore, executive chairman of the newly launched Cambridge startup City Therapeutics and the former founding chief executive of Cambridge-based Alnylam Pharmaceuticals, was less concerned about greater abortion restrictions or a rollback of the ACA, which remains popular, even among some conservative voters.
Maraganore was more concerned about the possibility that Trump might give Kennedy a leadership role at a federal public health agency — a possibility that Trump fanned at a recent rally, saying, “I’m going to let him go wild on health.”
Trump has pledged that Kennedy would be involved in his administration and named him to the Republican’s transition team. The president-elect hasn’t specified a potential job for Kennedy, the scion of the famous Democratic political dynasty.
“I’m happy to have voices that are contrarian, but the leadership of these agencies needs to be driven by science and evidence,” Maraganore said.
The head of the state’s largest nurses union, meanwhile, said she worried that a growing crisis in the state’s health care system wouldn’t be addressed — or could worsen — under a Trump administration.
“From the standpoint of people delivering care, this isn’t good,” said Julie Pinkham, president of the Massachusetts Nurses Association, who expressed fear that the state’s health reforms and ability to treat low-income patients could be in jeopardy. Trump and his inner circle, she said, “don’t see these as priorities they care about.”
Pinkham said the health care workforce in Massachusetts has been overburdened for years and needs higher federal reimbursements for insurance programs for many patients.
“Post-COVID, things are pretty fragile,” she said, suggesting longtime problems were aggravated by the shuttering of two more Steward Health Care hospitals over the summer. “We’ve just gone through a major hospital bankruptcy. The workforce is exhausted, and we have backups in the system.”
Jonathan Saltzman can be reached at [email protected]. Robert Weisman can be reached at [email protected].
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