Brings proposal’s total costs to $1.3 billion, completely refuting MNA cost “analysis” of $47 million

(BOSTON) – With the Secretary of State’s official guide to the 2018 November election hitting mailboxes across the Commonwealth, voters are learning more about the wide-reaching impacts the questions on this year’s ballot will have on the Commonwealth and its residents, including the high costs the state and Massachusetts patients will face if voters approve Question 1, which would implement rigid, government-mandated nurse staffing ratios at all hospitals – no matter their size, location, or the special needs of the communities and patients they serve.

The “Massachusetts Information for Voters” guide, also known as the “Red Book”, is provided to help voters make informed decisions on statewide ballot questions before they get to the polls. Information provided on each question includes text of the proposed language, statements from proponents and opponents, and a statement of fiscal consequences the question would have on Massachusetts, as projected by the Executive Office of Administration and Finance. 

According to their estimates, the mandate proposed by Question 1 will cost between $67.8 and $74.8 million for state-owned hospitals alone.

This figure, which doesn’t include the costs private, independent or community hospitals would face, completely discredits claims by Question 1 proponents that it would cost the state and the Massachusetts healthcare industry a total of $47 million.

Dan Cence, spokesman for the Coalition to Protect Patient Safety, released the following statement in response to the state’s latest costs estimates and the repeated attempts by the Massachusetts Nurses Association, which is leading the campaign in support of Question 1, to mislead voters and hide the truth about the devastating impacts this question would have:  

“If voters weren’t convinced before of the high costs they’ll face if Question 1 passes, they do now.

“The state’s own budget and finance office estimates that this irresponsible proposal will cost upwards of $74.8 million dollars per year – just for the four state-run hospitals still operating in Massachusetts. This is just the latest evidence that the MNA’s cost ‘analysis’ of $47 million is wildly inaccurate and was released in an effort to deliberately mislead voters about the impact this question will have on our economy, the entire healthcare industry, and on the ability for patients across the Commonwealth to access quality, affordable healthcare. 

“We have the best nurses in the country, the best doctors in the country, and the best hospitals in the country and Question 1 is putting all of that at risk.”

Below is the full text of the Question 1’s Fiscal Consequences statement as reported in the Massachusetts Information for Voters guide:

Learn more about the Coalition to Protect Patient Safety at and


Dan Cence