Report: Big Beautiful Bill could leave up to 200K Mass. residents uninsured
Photo I SHNS/Marek Studzinski on Unsplash
Massachusetts has 2 million people on MassHealth, the state's Medicaid program.
A federal law signed by President Donald Trump could leave as many as 203,000 more Massachusetts residents without health insurance, according to a Blue Cross Blue Shield of Massachusetts Foundation report.
Over 2 million people are on the state Medicaid program, called MassHealth, accounting for about 30% of the population. The analysis, prepared with the Urban Institute, projects that between 141,000 and 203,000 of those residents would lose coverage, most of them not because they were ineligible but because of paperwork lapses, missed deadlines or confusion over the new rules.
The One Big Beautiful Bill requires some Medicaid members to reverify eligibility every six months and certain childless adults to document at least 80 hours a month of work or related activities beginning at the end of 2026.
Researchers estimate that as a result, the state’s uninsured population could jump from a projected 227,000 uninsured adults under the age of 65 in 2026 without the law, to between 312,000 and 374,000 people with the law in place.
Roughly four out of five of those who lose Medicaid would end up uninsured, while a small share would shift into employer coverage or subsidized plans through the state’s Health Connector, according to the report.
"[This law is] a giant step backward and will do real harm to Massachusetts individuals and families," said Audrey Shelto, president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation. "Over the past 20 years, Massachusetts has made tremendous strides in getting more eligible residents enrolled in health insurance, in partnership with the federal government, through the expansion of the Medicaid program. The changes in [the law] add unnecessary administrative barriers to the already complicated process for getting and keeping coverage, especially when we know that most MassHealth members are already in working families."
The requirements would primarily affect adults under 65 enrolled in the MassHealth CarePlus program, which covers low-income adults without dependent children.
Unless the federal government delays the work rules — which it can do until 2028 — state lawmakers will have to decide whether to intervene with new measures or allow the new federal standards to take hold.
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