Trump’s Medicaid Bill: Who’s at Risk

Trump’s Medicaid Bill Could Cut MassHealth: Who’s at Risk 

Published July 1, 2025 | By VipLiveAlerts Pro News Desk

President Donald Trump’s Big Beautiful Bill is moving quickly through Congress, with a targeted deadline of July 4. At the heart of this legislation is a sweeping proposal to restructure Medicaid, which could have major consequences for millions of Americans — especially those in states like Massachusetts, where Medicaid is known as MassHealth.

Medicaid currently covers over 71 million Americans. In Massachusetts, more than 2.3 million residents rely on MassHealth for essential healthcare services. If this bill becomes law, it could reduce federal Medicaid spending by over $1 trillion by 2034 and result in at least 11.8 million additional Americans losing coverage, according to the Congressional Budget Office.

Who Is Most at Risk of Losing Coverage

Under the proposed legislation, several groups stand to be most affected.

Adults Without Dependents

The bill introduces new work requirements for Medicaid recipients between the ages of 19 and 64 who do not have dependents. Starting in 2026, these individuals must complete at least 80 hours per month of work, job training, or volunteer service to remain eligible. While the bill includes exemptions for parents of young children and people with documented disabilities, many fear that those who fall outside these narrow definitions will lose coverage — even if they are struggling to find work or manage caregiving responsibilities.

Older Adults Nearing Retirement

Adults ages 50 to 64 are especially vulnerable. A UC Berkeley Labor Center report notes that many in this age group are pushed out of the workforce due to health limitations or age-based employment discrimination. Yet under the new rules, they would still be required to meet work hour thresholds or lose coverage entirely. AARP has issued strong opposition to this provision, warning that it creates a coverage cliff for those too young for Medicare but not well enough to maintain full-time work.

Caregivers and People With Disabilities

While the bill claims to protect individuals with disabilities, in practice, proving disability status can be difficult. Parents or family caregivers — particularly those caring for children with autism or aging parents — could lose access to MassHealth unless they are officially recognized and meet new administrative standards. This places an additional burden on families already managing complex healthcare needs.

Impact on Massachusetts (MassHealth)

In Massachusetts, the proposed changes could significantly erode the state’s healthcare infrastructure. MassHealth covers nearly one in three residents, including children with special needs, disabled adults, and low-income families. Losing access to this coverage would affect not only individual health outcomes but also the stability of hospitals, clinics, and long-term care providers that depend on Medicaid reimbursements.

If passed, the bill’s changes would begin in 2026 and could lead to large-scale disenrollment from MassHealth. The state would be required to implement work requirements and manage reduced federal funding, putting pressure on already strained resources. Adults without dependents, part-time workers, older residents, and caregivers could lose coverage due to new eligibility rules or administrative hurdles. Rural hospitals and clinics relying on Medicaid funding may be forced to cut services or close, especially in Western and Central Massachusetts.

Advocates warn that unless the state fills the funding gaps left by the federal government, millions of residents will lose coverage. Additionally, delays and red tape could lead to wrongful terminations of benefits, even for those who still qualify under the new rules.

Rural and Community Health Centers at Risk

Community clinics and rural hospitals across the country — including those in Western Massachusetts — may be forced to close if Medicaid funding is reduced. These facilities rely heavily on Medicaid payments to stay open. Although the bill includes a proposed $25 billion rural stabilization fund, health economists and policy leaders argue it will fall far short of covering the losses. Without intervention, patients may have to travel several hours to access critical services like childbirth, emergency care, or specialty appointments.

Promises vs. Policy Reality

Despite previous promises not to touch Medicaid, Trump’s current proposal includes deeper cuts than any of his prior legislative efforts. The bill also reintroduces capped block grants and per-capita limits on federal Medicaid funding, strategies that would shift long-term costs to states. For a state like Massachusetts — which expanded Medicaid under the Affordable Care Act — this could mean fewer benefits, tighter eligibility, and inevitable enrollment drops.

What Can Individuals Do Now

Those currently enrolled in MassHealth or providing care for someone who is should begin preparing immediately. Individuals should verify their eligibility status, ensure all disability documentation is up to date, and contact MassHealth representatives for clarification. It is also important to stay informed through trusted healthcare advocacy organizations and legal aid services.

Conclusion

The proposed Medicaid changes represent one of the most significant healthcare policy shifts in recent decades. For millions of Americans — particularly older adults, people with disabilities, low-income workers, and family caregivers — the risk of losing health coverage is real and imminent. In Massachusetts, where MassHealth supports a broad cross-section of the population, the impacts could be particularly severe.

As the legislation moves forward, individuals, families, and healthcare providers must prepare for a more complex and restricted system. Whether or not the bill becomes law, its implications are already reshaping the future of Medicaid in America.

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