Up to 350,000 people in Massachusetts are at risk of losing their Medicaid coverage over the next decade, and 104,000 could lose some public food assistance as a result of the sweeping tax and spending bill that President Trump signed into law in July, according to a new analysis by a Washington D.C. think tank.
The estimates from the left-leaning Center for Budget and Policy Priorities, which were shared in a news release from Senator Elizabeth Warren‘s office, are the most grim yet as state officials and health experts await the implementation of the federal budget’s new restrictions on Medicaid, which are scheduled to phase in over the next four years.
The new Medicaid restrictions include more frequent eligibility checks and a mandate that most healthy recipients either work, attend school, or volunteer at least 80 hours a month.
“We know the impact of the health care cuts will be devastating for families across Massachusetts, and we hear increasing concern and confusion among the most at-risk residents,” said Alex Sheff, senior director of policy and government affairs at Health Care for All, a state nonprofit that works to improve health care access.
That organization anticipated Massachusetts could lose up to $3.5 billion annually in federal health care funding.
The budget is expected to cut $186 billion from SNAP and $1 trillion from Medicaid nationally in the coming decade and support a $4.5 trillion tax cut.
The Center for Budget and Policy Priorities’ estimate of the impact on Massachusetts Medicaid recipients is based on a review of how similar work requirements in Arkansas and Georgia affected those states’ coverage rates, staff with the think tank said.
Massachusetts officials have previously said they anticipated about 300,000 people could lose insurance over the next decade. The Congressional Budget Office, meanwhile, had predicted about 326,000 would lose coverage in the state.
About two million people in Massachusetts now rely on Medicaid for their insurance coverage.
Another 8,000 people could lose private insurance coverage due to canceled tax credits that helped lower and middle income people, as well as small businesses, afford insurance, the think tank estimated.
With about 5 percent of the state’s population expected to lose their insurance coverage by 2034, according to Health Care for All, health care providers in the state are already beginning to react. UMass Memorial Health, which is facing an $86 million operating loss, has shut down clinics and a substance use treatment center, and is expecting to close a behavioral health center. Those cuts are in part driven by the anticipated loss of Medicaid revenue, hospital officials have said. And health experts say more such cuts are likely.
The budget added broader work requirements to the food assistance program for low income people, SNAP, the Supplemental Nutrition Assistance Program, which would contribute to reduced or canceled benefits. The state will also have to pay up to $390 million more for the program, the think tank estimated. Almost 662,000 Massachusetts households benefit from SNAP, the state Department of Transitional Assistance reported.
Energy costs, too, will increase, the policy center predicted. The budget cut $480 billion in clean energy tax credits, which will make wind and solar power more expensive. By 2035, those cuts could translate into energy bills that are nearly $300 more a year for Massachusetts families.
The budget’s impact on Medicaid is scheduled to be phased in over the next 10 years, and even some Republicans have expressed concern about the extent of the cuts. Missouri Senator Josh Hawley introducing legislation last month that would reverse some of the effects of the budget.
Warren wants Democrats to demand a rollback of social service cuts in exchange for votes Republicans need to prevent a government shutdown this fall.
“If Republicans want Senate Democrats to provide votes to fund the Trump administration, they can start by restoring the health care that they ripped away to finance more tax handouts for billionaires,” Warren said Friday. “This government funding fight is about saving health care and lowering costs for millions of Americans.”
State officials, meanwhile, are preparing a massive outreach campaign to inform people at risk of falling through the cracks of the new Medicaid requirements. State officials have said people with mental health conditions, substance use disorders, or who go to the doctor infrequently are among those they are most concerned could lose coverage they are entitled to receive.
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