Massachusetts wins $30 million to improve rail safety in West Springfield. WEST SPRINGFIELD - The Healey-Driscoll administration and U.S. Rep. Richard Neal announced that Massachusetts has secured $30 million in federal funding for critical rail infrastructure improvements in West Springfield that will improve safety and reliability and reduce traffic delays. The funding, awarded to the Massachusetts Department of Transportation (MassDOT) through the Federal Railroad Administration's Railroad Crossing Elimination Grant (RCE) program, will support the Front and First Street Grade Crossing Elimination Project and continue to lay the groundwork for west-east rail. The latest funding brings the total federal funding awarded for Compass Rail to more than $320 million. "We're working every day to bring home funding for Massachusetts communities that will enhance safety and improve quality of life," Gov. Maura Healey said. "This award will allow us to make badly needed improvements in West Springfield that will make train service safer and more reliable while also reducing traffic congestion. It's the latest example of how we're leaning into transportation improvements in Western Massachusetts and delivering west-east rail. I'm grateful for the leadership of our congressional delegation and MassDOT to secure this funding and deliver for our communities." The Front and First Street Grade Crossing Elimination Project will replace two railroad crossings with a new roadway overpass, allowing vehicles and pedestrians to travel without waiting for trains to pass. Located near the CSX Intermodal Terminal in West Springfield, these crossings are frequently blocked by trains entering and leaving the facility, sometimes multiple times a day. The project will reduce these delays while supporting more efficient freight operations. It is a partnership between MassDOT's Rail and Transit Division and the Highway Division. "For those who have lived in Agawam or West Springfield, they know the challenges and inconvenience posed by this crossing. That's why I'm pleased to join with MassDOT, CSX, and the towns of Agawam and West Springfield to announce $30.3 million in federal funding that will address a longstanding issue, as we further our efforts to make west-east rail a reality," Neal said, adding that this is the third significant rail announcement in the region in recent weeks; others include a $130 million CRISI grant for the Springfield Hub Modernization Project at Union Station, and a groundbreaking on rail infrastructure improvements in Pittsfield that will make the Berkshire Flyer permanent and lay the groundwork for expanded passenger rail. "With this $30.3 million grant for the Front Street Flyover, this marks more than $300 million that has come to Western and Central Massachusetts through the Bipartisan Infrastructure Law, legislation I was proud to help write as chairman of the Ways and Means Committee. This is a great day for these communities, and I am grateful to the Healey-Driscoll administration for continuing to bring many of these projects that once seemed unattainable to fruition." The project is part of MassDOT's Compass Rail program, which aims to expand passenger rail service across Massachusetts, including west-east rail connections between Boston, Springfield, and Pittsfield. "It is great news that the Front Street Flyover Project is set to receive over $30 million dollars in federal funding assistance," Agawam Mayor Chris Johnson said. The project is key to eliminating traffic congestion, which will benefit first responders and residents."

Medicaid can't opt out of gene therapies, so planning matters more, says Katelyn Meyer, Pharm.D. AMCP Nexus 2026. MassHealth's Katelyn Meyer, Pharm.D., says mandatory coverage, young patients and an unpredictable FDA make planning for new specialty drugs a challenge. Medicaid programs face a different set of problems than commercial plans when new cell and gene therapies come to market. They can't leave a drug off the formulary, according to Katelyn Meyer, Pharm.D., of MassHealth. Many of the rare genetic diseases these therapies target affect children, a group Medicaid covers in large numbers. Meyer, a clinical pharmacy manager with MassHealth at the Massachusetts Executive Office of Health and Human Services, explored these issues in a session titled "Ahead of the Curve: Emerging Specialty Therapies and Managed Care Readiness," this week at the AMCP Nexus 2026 conference in San Diego. In this interview with Managed Healthcare Executive, she explained what makes the specialty pipeline hard for Medicaid to plan for and how plans can prepare. Coverage without a choice. Medicaid must cover drugs from any manufacturer that takes part in the Medicaid Drug Rebate Program, Meyer said. That includes drugs that earned accelerated approval or carry questions about how long their benefit lasts. This makes it hard to predict how many patients will need a therapy. She also pointed to a trend of FDA approvals that reach beyond the patients studied in trials, such as a therapy tested only in children being approved for adults. How will health insurance change in 2027? Share your outlook on coverage, Medicare Advantage, PBM reform and federal policy in MHE's annual State of the Industry survey. It's 15 questions and takes less than 10 minutes. All respondents receive early access to the full industry report this December. "For Medicaid, that puts us in a tough position because there's no data," she said. Paying for an uncertain benefit. Some manufacturers are willing to sign outcomes-based or value-based agreements tied to real-world results, Meyer said. Others aren't, and payers often have no lever to change that. Newer companies whose first product is a cell or gene therapy may not have the capital to pay out $1.5 million if a drug fails. She called the agreements worth pursuing but imperfect and "often administratively very challenging to actually do." Start with the standard of care. To prepare for therapies arriving in the next year or two, Meyer recommended a landscape review. In hemophilia, MassHealth hasn't seen much interest in gene therapy because patients already do well on existing treatments. A therapy that extends survival in a fatal disease fills a larger unmet need and will likely see more uptake. Centers that took part in clinical trials can also offer insight into real-world use. However, she cautioned against doing too much too early. "The FDA has been fairly unpredictable as of late," she said, noting that expected approvals have been rejected and vice versa.

2028 referendum supporters say they have enough signatures to suspend new Mass. abortion law. Now what? October 30, 2026 Happy Halloween Eve! (All Hallows Eve-eve?) The National Weather Service says the trick-or-treating forecast "looks like a treat," and Salem is expecting even bigger crowds than usual for its 400th anniversary. Here's a guide for visitors. (Reminder: today is also the last day of in-person early voting for the midterms in Massachusetts, in case you want to get ahead of the Tuesday rush.) Now, to the news: One ballot battle after another: Supporters of a petition to hold a 2028 referendum on Massachusetts' new abortion law say they've collected nearly double the signatures necessary to suspend the law. The "Compassionate Care Coalition" announced yesterday that they collected 97,276 signatures from Massachusetts voters in support of their effort. They need to file at least 37,289 by next Friday to put the referendum on the 2028 ballot - and at least 49,716 to suspend the law until that election. "We are grateful to every volunteer, pastor and parish staffer who carried a clipboard," coalition chair Sam Miele said in a statement. "Because of them, voters will have the final say." * Catch up: The law - which is set to take effect next Sunday, Nov. 8. - gets rid of restrictions on abortions for pregnancies beyond 24 weeks, putting the decision up to "the professional judgment" of the doctor. Gov. Maura Healey signed it in August, saying the measure gets the government out of "incredibly rare," painful choices for patients. Antiabortion activists and Catholic Church leaders backed the repeal effort last month, deriding the abortion law as one of the most permissive in the country. * What's next: The final tally of signatures still needs to be certified by Secretary of State Bill Galvin's office. Galvin spokesperson Debra O'Malley said yesterday that they had "received a small quantity of petitions," but expect more to be filed before the Nov. 6 deadline. O'Malley said it typically takes one to two weeks to review and certify the signatures, a process that doesn't start until after all of them have been filed. * FYI: The potential suspension of the law only takes effect after Galvin's office has certified the signature total. Healey also has the ability to block - or even undo - the suspension by attaching an emergency preamble to the law (like she did with the 2024 gun law) anytime up until the 2028 election. In a statement Thursday, Healey spokesperson Jacqueline Manning said the governor "continues to monitor the referendum process and evaluate options." "This law is for parents facing some of the most painful and devastating circumstances imaginable and making sure these decisions are made between a woman and her doctor," Manning said. Meanwhile on Beacon Hill: Consider Healey's proposal to suspend the state's gas tax all but officially dead. The Massachusetts Senate - whose leaders had actually expressed an inkling of openness to the idea - released its closeout budget bill Thursday. And while the $2.6 billion spending bill includes a number of policy add-ons, a gas tax suspension is not one of them. It comes after the House left out the proposal from its version of the bill last week. * What is in it? Like the House, the Senate proposal dedicates $1.8 billion for MassHealth and includes money to hire 200 new caseworkers at the agency that handles food stamps and other benefits. State House News Service has more here on the other policy proposals the Senate added to the bill. Green Line ghosting: The MBTA is giving riders more tricks than treats this weekend. The Green Line's downtown tunnel between North Station and Kenmore will be closed Saturday and Sunday due to signal upgrades - as will part of the B branch and the southern E branch. Click here for more on shuttle buses and other free public transit alternatives. * Plan ahead: An even bigger, nine-day partial Green Line closure (affecting the C branch, too) starts next weekend. Get the details on that here. * Meanwhile: The T announced this morning that Red Line trains can officially go up to 50 mph between North Quincy to JFK/UMass, as the agency promised last week. He's back: After a record four sold-out shows at Fenway Park this summer, Noah Kahan is running it back. The Vermont native announced a 2027 stadium tour yesterday that includes four more concerts at Fenway (rather than Gillette Stadium; make of that what you will). Those shows take place May 29 to June 2 - with tickets going on sale in November. Save the date: Boston Mayor Michelle Wu announced that this year's final Open Newbury - a special "holiday stroll" edition - will be Dec. 6. P.S. - Which two Massachusetts cities will get federal poll monitors on Election Day? Take our Boston News Quiz and see how well you know the stories we covered this week compared to other WBUR readers.