Massachusetts Health Program Faces Dismantling

Trump-era policy changes threaten coverage for thousands in the Bay State.

A popular Massachusetts health program, once a model for Obamacare, may be facing significant setbacks due to federal policy shifts, sparking fears that many residents could lose their healthcare coverage.

Potential Coverage Losses

New federal measures could strip health insurance from as many as 25% of the roughly 400,000 individuals enrolled in the Massachusetts Health Connector, according to state projections. The legislative changes aim to cut federal spending.

These changes could bring back coverage gaps that state leaders had worked to eliminate since Massachusetts became the first state in the U.S. in 2006 to mandate nearly all residents have health insurance. According to the Kaiser Family Foundation, about 95.8% of Massachusetts residents had health coverage in 2022. KFF data shows.

“The idea of needing to unwind that now and pull back on that promise and commitment is really frustrating and heartbreaking and cruel and counterproductive,”

—Audrey Morse Gasteier, executive director of Massachusetts’ health insurance marketplace

**President Donald Trump’s** administration asserts the changes, including stricter documentation requirements, are needed to combat fraud, waste, and abuse. The Congressional Budget Office estimates the Affordable Care Act changes will cut health care spending by $1.1 trillion over ten years.

Fear and Uncertainty Among Immigrant Communities

In Lawrence, **Kesia Moreta** reports that some residents are already avoiding the state’s health care network due to fears related to immigration enforcement. Some clients have missed meetings, worried that being enrolled in health insurance might hurt their chances of staying in the U.S. legally.

One father, whose U.S.-born son has epilepsy, even deleted all emails related to his health plan and stopped answering calls from the Connector out of fear of deportation.

“Is this going to get me deported?”

**Moreta** recounted his words with distress, “That breaks our hearts.”

Incremental Dismantling of the ACA?

**Vicky Pulos**, an attorney for the Mass Law Reform Institute, suggests that after failing to repeal the Affordable Care Act outright, Republicans are now dismantling it piece by piece.

“It really seems like this is just a less transparent way of effectively dismantling the accomplishments of the Affordable Care Act in both Medicaid and the marketplace,”

—Vicky Pulos, attorney for the Mass Law Reform Institute

She warns that the changes “will massively drive up the number of uninsured but without openly repealing the ACA.”

Documentation and Eligibility

The new bill mandates that individuals provide more documentation of their income, household size, and immigration status to qualify for premium tax credits. **Morse Gasteier** fears this will create “friction, red tape and delays.”

The Trump administration argues that these proposals will stop immigrants from “stealing taxpayer-funded health care benefits meant for American citizens.” However, federal money isn’t used to provide health insurance to those in the U.S. illegally.

Around 60,000 noncitizens legally residing in the U.S. could lose access to federal premium tax credits. These individuals include victims of domestic violence and human trafficking, refugees, and asylum seekers. Without the credits, premiums could rise significantly, to $500 or $600, which many cannot afford.

Broader Economic Impacts

**Morse Gasteier** notes that immigrants enrolled in the state marketplace tend to be younger and healthier, which helps lower premiums for everyone. She worries that if people believe help is no longer available, “entire populations will just sort of give up on health insurance.” That, in turn, could hurt the state’s economy.

In Lawrence, advocates emphasize that the burden will disproportionately affect people with chronic health issues like diabetes and heart disease. **Vilma Martinez-Dominguez**, CEO of GLCAC, says that “If you’re not healthy, let me tell you, you can’t work. If you can’t work, you can’t pay your bills. It’s just as simple as that.”