Massachusetts residents could lose food and health benefits under the new federal law
Massachusetts residents could lose access to food and health assistance under provisions of the recently passed federal budget law known as the “One Big Beautiful Bill Act,” according to two new analyses.
A report from Boston Indicators, the research center at the Boston Foundation, estimates that more than 40,000 adults in Greater Boston may be at risk of losing Supplemental Nutrition Assistance Program (SNAP) benefits when the law takes effect. The changes extend work requirements to older adults, reduce exemptions for parents, and remove eligibility for some legally present immigrants.
The study found that gateway cities, such as Lawrence, Brockton, Lynn, and Lowell, are especially vulnerable, with more than a quarter of their residents relying on SNAP. Lawrence’s 01840 ZIP code has one of the highest concentrations of SNAP recipients.
“This analysis aligns with several other studies of how this inhumane plan will affect thousands of people across the region,” said Lee Pelton, president and CEO of the Boston Foundation, in the release. “It also underscores the critical importance we see of investing to support local food systems in cities and towns across the state to better prepare for what will likely be a sharp increase in need from families in the coming months.”
The Boston Indicators report estimates that 31,000 adults without dependents would be subject to new work requirements, as well as 11,000 parents who were previously exempt because their children were under 18 years old. The law lowers that cutoff to parents of children under 14.
Another provision would revoke eligibility for certain legally present immigrants, including refugees, asylees, victims of trafficking, and parolees. If the rules had been in place in July, about 9,600 legal immigrants in Massachusetts would have lost SNAP benefits.
“Instead of working to ensure families are fed and have access to the food they need, the Act turns SNAP into a paper chase for families and states,” said Peter Ciurczak, who authored the analysis for Boston Indicators. “While we won’t know the precise impacts until the specifics are put forth, these new requirements will put thousands of residents one paperwork error or missed shift away from losing some or all of their basic food assistance.”
A separate report by the Blue Cross Blue Shield of Massachusetts Foundation, prepared with the Urban Institute, projects that between 141,000 and 203,000 people statewide could lose MassHealth coverage as a result of the same law.
The report highlights two key provisions: eligibility redeterminations every six months instead of annually, and new work reporting rules requiring at least 80 hours per month of employment or qualifying activities.
“H.R. 1, and specifically these two provisions, are a giant step backward and will do real harm to Massachusetts individuals and families,” said Audrey Shelto, president and CEO of the BCBSMA Foundation, in the release. “The changes in H.R. 1 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.”
Analysts noted that many residents could lose coverage not because they are ineligible but due to paperwork problems, such as late forms or missing documentation.
“The projected coverage losses are driven largely by administrative complexity rather than changes in eligibility,” said Kaitlyn Kenney Walsh, vice president of policy and research at the BCBSMA Foundation. “When individuals are required to re-verify their information every six months and submit regular proof of work or other activities, it creates obstacles to continued coverage. These requirements are particularly onerous and complex for families trying to make ends meet — they are time-consuming and can be overwhelming.”
The report estimates that in an average month, 85,000 to 147,000 more people under age 65 would be uninsured, raising the total uninsured population from 227,000 to between 312,000 and 374,000 — a 37% to 65% increase. Marginalized groups, including non-native English speakers, are expected to face the greatest difficulty navigating the new requirements, according to the analysis.
Interruptions in coverage could also worsen health outcomes.
“Interruptions in Medicaid coverage, which would be caused by both the six-month redetermination requirement and the new work reporting rules, create churn. Without health insurance, people often forgo getting necessary care or prescriptions. This [disruption] leads to individuals developing more advanced illnesses that are more difficult and costly to treat,” Walsh said. “After the Affordable Care Act expanded coverage, we saw that patients were generally healthier because of regular access to primary care. Interruptions in coverage undo those gains.”
Walsh added that mitigating the effects of the law would require broad outreach from state agencies, community organizations, and providers to help people navigate the new processes and maintain eligibility for Medicaid.
The combined findings from the two reports suggest that families may face multiple losses simultaneously, with some at risk of losing both food assistance and health coverage.
The Boston Indicators analysis also notes that the law shifts more of SNAP’s administrative costs to states. Massachusetts’ share would rise from 50% to 75%, costing an additional $58 million in fiscal year 2025, for a total of $175 million. By 2028, a new formula tying federal reimbursement to payment error rates could result in the state incurring approximately $260 million more, based on Massachusetts’ 2023 error rate.
Both the Boston Foundation and BCBSMA Foundation underscore the importance of preparing for increased need as the provisions of the law take shape.
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