A Massachusetts Model For Medicaid Work Requirements
By Evan Horowitz, Center for State Policy Analysis, Tisch College, Tufts University, and Kimberly Goulart, Boston Indicators
November 20, 2025
The “One Big Beautiful Bill Act (OBBBA)” cuts Medicaid in an unusually indirect manner. Rather than lowering funding levels for our state’s Medicaid program, MassHealth, the law requires every state to adopt new eligibility checks and work requirements, assuming these added hurdles will shrink enrollment and reduce spending. Reviewing the latest research, and talking to leading experts about how Massachusetts can best safeguard MassHealth, this new report includes background on the new MassHealth work and eligibility requirements, lessons from other states, and a proposed “Massachusetts Model” for adapting in a way that protects our residents and coffers while making state data systems more integrated and efficient.
