A nurses' strike is averted, while a lack of urgency prevails on Beacon Hill

With less than eight hours to spare, Brigham and Women's Hospital nurses and Mass General Brigham late Wednesday managed to avert a potentially historic open-ended strike.

Divided over cost-of-living increases, limits on temporary travel nurses and health insurance contributions, the parties negotiated for hours Monday and made "some progress" — but not enough to call off the strike. Even as Gov. Maura Healey and Boston Mayor Michelle Wu stopped by the session and called on the sides to strike a deal, it seemed likely thousands of nurses would end up streaming through Longwood Medical Area by 7 a.m. Thursday. No additional talks were scheduled.

But then the nurses — represented by the Massachusetts Nurses Association — and hospital leaders resumed bargaining Wednesday afternoon.

At 11:25 p.m. Wednesday, the MNA announced a "tentative contract agreement," featuring language stating that MGB does not intend to replace Brigham nurses with temporary workers, new tracking of temporary and floating nurses, two new step increases for nurses at the top of the pay scale, $1,000 prorated bonuses for all nurses below the top step, and current nurses continuing to have no insurance premiums. Twelve minutes later, MGB issued its own statement that the agreement "was reached within the financial limits of the hospital's last, best and final offer presented on Oct. 10."

Nurses had rejected that contract offer, spurring the renewed threat of an indefinite strike. The MNA says nurses must now vote to ratify the tentative deal, but no date has been announced yet. 

With that one complicated and politically-charged negotiation resolved, there are still a dozen active conference committees on Beacon Hill — with no compromises in sight on key issues such as primary care reform, energy affordability and economic development.

Senate President Karen Spilka, who in late September said she wanted to see a "lot of" legislative accords emerge before Election Day, called the ongoing stalemate "unacceptable" Monday. She also voiced skepticism over new legislative rules that have emboldened lawmakers to punt action on consequential bills well beyond the traditional July 31 deadline and into the lame-duck session.

The Ashland Democrat said the "Legislature must act with a sense of urgency," and warned that, "Unless we see movement soon, I cannot support extending the time for conference negotiations again in our joint rules next session."

A transatlantic Senate trip to meet with U.K. dignitaries and focus on energy policy may further drag out negotiations. Spilka, who traveled abroad Tuesday and returns to the U.S. this weekend, is joined by Sens. Dylan Fernandes, Paul Feeney, Cindy Friedman, Adam Gomez, Paul Mark and Pavel Payano.

Feeney is the lead Senate negotiator on pet ownership and animal welfare legislation. Friedman, who's helming talks on both primary care and violence prevention for healthcare workers, missed the annual "Super Bowl" of healthcare policy for the trip — though her staff attended the Health Policy Commission's cost trends hearing.

Rep. John Lawn, Friedman's co-chair on the Health Care Financing Committee, was at the hours-long event that offered bleak glimpses into affordability pressures that are intensely straining patients, providers and insurers.

Average total healthcare costs for families topped $34,000 last year, according to HPC Executive Director David Seltz. Family health insurance premiums were $7,000 back in 2000, but have climbed to nearly $30,000 and are expected to hit $50,000 in 2032.

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A revamped primary care payment model may be tied up in closed-door talks, but MassHealth is moving forward with a voluntary hospital global budget approach for an upcoming federal waiver. MassHealth chief Dr. Ryan Schwarz said the policy shift — intended to make care more efficient and slash costs — is incorporated within the Section 1115 Waiver Demonstration extension request, which the agency plans to file by the end of the year and that will cover 2028-2032.

Schwarz took over the state's Medicaid office in June, as Mike Levine departed for a city government job in San Francisco. Leadership in the Healey administration, which is frequently in flux, is undergoing more changes.

Melissa Hoffer, the country's first Cabinet-level climate chief, left the administration Monday ahead of becoming president of Vermont Law and Graduate School next month. In a farewell speech to environmental advocates, Hoffer stressed the interconnectedness of climate action and affordability, called for a "hard stop" on natural gas infrastructure and for it to be phased out by 2050, and acknowledged the state is "paying for stuff that we don't need" as it simultaneously invests in gas and electric systems.

Healey, who has openly backed natural gas pipelines, on Tuesday tapped Aladdine Joroff to replace Hoffer. After serving as Boston's climate policy director, Joroff joined the administration as deputy climate chief in August 2024.

The Department of Fire Services this week began accepting applications for the next state fire marshal, with Jon Davine slated to retire on Jan. 22. An advisory council also made progress on its search for the next Department of Higher Education commissioner, as members reviewed a draft profile that could be posted next week.

Elizabeth Dionne, the Republican treasurer candidate who lost to incumbent Deb Goldberg, has already set her sights on a new election. Dionne wants to be the next Massachusetts Republican Party chair, and she pledged to do the job without getting paid. Chair Amy Carnevale announced Monday she wouldn't seek reelection in January and told members, "Massachusetts remains a challenging environment for Republicans, and there is still considerable work ahead."

It remains unclear whether Republican Rep. John Gaskey of Carver will stay in the House for another term, or if Democrats indeed picked up four seats as Speaker Ron Mariano has claimed. Shifting vote tallies — including Gaskey first claiming victory, followed by Democratic challenger Sarah Hewins notching a slim lead and Wareham revising its preliminary results — have both candidates angling for recounts.

KELLER AT LARGE: 8:30 a.m., WBZ-TV. Political analyst Jon Keller talks to state Rep.-elect Daniel Darris-O’Connor about how the 19-year-old Billerica Democrat beat an eight-term incumbent, what he intends to focus on in office and generational differences in local politics.

@ ISSUE: 9:30 a.m., NBC 10. Reporter Matt Prichard sits down with MassGOP chair Amy Carnevale.

ON THE RECORD: 11 a.m., WCVB. NewsCenter 5's Ed Harding and Sharman Sacchetti host a conversation with Congresswoman Katherine Clark. Political analysts Mary Anne Marsh and Ginny Buckingham join for a roundtable discussion.

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