{"id":70,"date":"2026-05-26T13:10:10","date_gmt":"2026-05-26T13:10:10","guid":{"rendered":"https:\/\/worcestermovingreport.com\/?p=70"},"modified":"2026-05-26T13:10:10","modified_gmt":"2026-05-26T13:10:10","slug":"health-care-coverage-for-immigrants-remains-in-limbo","status":"publish","type":"post","link":"https:\/\/worcestermovingreport.com\/?p=70","title":{"rendered":"Health care coverage for immigrants remains in limbo"},"content":{"rendered":"
\n

ABOUT 30,000 LAWFULLY <\/mark><\/strong>present immigrants in Massachusetts lost their subsidized health coverage through the state insurance exchange on January 1, as a result of President Trump\u2019s big 2025 tax and spending bill, and the state has yet to offer them a bridge. That\u2019s one of the more worrying gaps that Victoria Poulos, a senior health law attorney at the Massachusetts Law Reform Institute, sees in an otherwise aggressive state response to sweeping federal cuts to Medicaid and marketplace insurance programs. <\/p>\n

Read more How a shuttered hospital site in Lynn is being transformed into affordable housing for seniors<\/a><\/p>\n

Poulos joined John McDonough of the Harvard TH Chan School of Public Health and Paul Hattis of the Lown Institute on the monthly Health or Consequences episode of The Codcast. <\/p>\n

The federal law enacted last July, which Trump dubbed the One Big Beautiful Bill Act, is \u201cthis latest and perhaps the greatest challenge\u201d to Medicaid and the state Connector Care program, Poulos said. The state estimates the law will cost Massachusetts $3.5 billion a year in lost federal revenue once fully implemented, and could leave 300,000 residents uninsured. <\/p>\n

\u201cIt wreaked havoc,\u201d Polous said. <\/p>\n

She noted that there are efforts to use Medicaid data to aid ICE enforcement, among the pile of administrative and regulatory changes packed into the bill. The administration contends that the changes are aimed at cracking down on fraud, waste, and abuse. <\/p>\n

Poulos zeroed in on how the bill narrowed immigrant eligibility for both Medicaid and marketplace coverage to just three categories: lawful permanent residents, certain Cubans and Haitians with particular immigration statuses, and residents from the Marshall Islands, Palau, and Micronesia \u2014 a small population in Massachusetts. <\/p>\n

The Connector Care program \u2014 a state exchange where individuals can buy insurance, including with subsidies for those with lower income \u2013 had previously covered a broad range of lawfully present immigrants with work authorization. <\/p>\n

A second wave hits in October, when an estimated 2,500 MassHealth enrollees \u2014 refugees, asylum recipients, trafficking victims, domestic violence survivors \u2014 lose federal Medicaid eligibility. <\/p>\n

On the Connector Care side, Massachusetts is in better shape than most states on premium affordability. When enhanced federal tax credits expired at the end of 2025, the Connector drew on a trust fund to make up $250 million of the difference. <\/p>\n

Read more Health insurers seek double-digit premium hikes on small businesses, again<\/a><\/p>\n

Work requirements are the other looming deadline. Starting January 1, the roughly 300,000 to 360,000 adults enrolled in MassHealth Care Plus \u2014 the state\u2019s Medicaid expansion program \u2014 will have to demonstrate 80 hours per month of work, community service, job training, or half-time school enrollment, or qualify for an exemption. The state plans to use claims data to automatically identify people who meet exemptions, sparing some the paperwork burden. But key federal guidance is still pending, and Poulos said execution is uncertain. <\/p>\n

\u201cThe state has not always been good in its IT system changes, its training, its customer service,\u201d she said. <\/p>\n

The same population faces more frequent eligibility renewals \u2014 every six months instead of annually. \u201cEvery time that happens, a lot of people drop off just because they can\u2019t handle the paperwork,\u201d Poulos said. <\/p>\n

On the state\u2019s overall response, Poulos gave mixed marks. She credited the Healey administration and Legislature for signaling they want to minimize coverage losses, including funding an outreach campaign modeled on the post-pandemic Medicaid unwinding effort. But she was pointed about the immigrant coverage gap. <\/p>\n

\u201cThe Connector Authority, the connector board, the connector staff \u2014 they\u2019re fabulous, but they have not come up with a solution. They have not stepped up, nor has the governor, the state, the Legislature,\u201d she said. \u201cThat would not be a passing grade in my book as yet, but there\u2019s still time.\u201d <\/p>\n

On the episode, Hattis, McDonough, and Poulos discuss the federal law and its consequences for MassHealth and the Connector (2:15), what the state can do to limit coverage losses (10:30), and immigrant insurance eligibility cuts (12:00). <\/em> <\/p>\n

Read more SJC ruling opens a path for legislative audit without ending the bitter dispute<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

On the monthly Health or Consequences episode of The Codcast, John McDonough of the Harvard TH Chan School of Public Health and Paul Hattis of the Lown Institute talk with Vicki Poulos, a senior health law attorney at the Massachusetts Law Reform Institute. 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