The plan, still in the talking stage, would hand a small circle of Democrat-run states the power to set their own rules on shots — bypassing federal guidance entirely. That guidance has shifted under Health Secretary Robert F. Kennedy Jr., who dismantled the old CDC vaccine panel — long seen by critics as a rubber stamp for Big Pharma — and replaced it with members willing to challenge the establishment narrative.

Kennedy’s shake-up has slowed the release of new COVID shot recommendations, prompting a scramble in statehouses. Without federal recommendations, insurers aren’t bound to cover costly doses — roughly $120 a pop — leaving many local health boards unwilling to risk scarce taxpayer funds on shots that could sit in storage.

In practice, Healey’s regional alliance would let Democrat governors decide who gets what shots, when, and under what conditions — a move critics say sounds less like “public health” and more like a blue-state board of health overlords. And in an election year, that’s a political booster shot Healey is clearly happy to give herself.

Opponents warn the plan could resurrect the COVID-era playbook of vaccine passports, travel restrictions, and “papers please” politics that turned neighbors against each other and small businesses into enforcement checkpoints. “Never let a good crisis go to waste” seems to be the guiding motto here.

This year’s flu and RSV vaccines were approved weeks late, and it’s still unclear whether the Trump administration will recommend COVID shots at all. In the meantime, rural regions like Berkshire County have already put vaccine orders on ice. “We’re really seriously considering not doing COVID vaccines this year,” admitted Laura Kittross, a public health program manager working with 18 Western Massachusetts towns. For communities that don’t even have a CVS on Main Street, the idea of paying out of pocket for doses that might never be used is a nonstarter.

The insurance angle is another sticking point. While Massachusetts’ largest insurer, Blue Cross Blue Shield, says it might cover vaccines outside CDC recommendations, there’s no guarantee. Smaller insurers have long relied on the CDC stamp as their north star — remove that, and the whole system is flying blind.

Dr. Robbie Goldstein, Healey’s public health commissioner, openly admitted the state is “building the plane while we fly it.” Critics say it’s more like “building the mandate while you dodge accountability.”

Healey’s proposal isn’t finalized, but the writing’s on the wall: she’s looking to bypass Washington, pick a fight with Trump, and put more control over your health decisions into the hands of a few Democrat politicians. For Massachusetts residents who still remember the lockdowns, business closures, and endless shifting rules of 2020–21, the thought of a regional vaccine cartel run out of Beacon Hill is enough to make you roll up your sleeve — in a facepalm.