Federal Changes to MassHealth: What Every Massachusetts Family Should Know
Notice: This article summarizes changes to federal MassHealth (Medicaid) rules in Massachusetts. It does not replace legal, immigration, or advice from an authorized MassHealth representative. If you have questions about your specific situation, contact MassHealth at 1-800-841-2900 (TTY: 711) or a certified assister.
Starting in October 2026, some federal Medicaid rules will change the way hundreds of thousands of families in Massachusetts access and maintain MassHealth coverage.
And broader changes are expected in January 2027.
The good news, according to MassHealth itself, is that most members will not be affected.
But for those who are affected, understanding what is changing and what to do about it could make the difference between keeping their family’s health coverage and losing it because of a requirement or deadline they did not know about.
These changes are part of the “One Big Beautiful Bill Act,”
The federal law signed in 2025 that cuts $900 billion from Medicaid nationwide.
In Massachusetts, as many as 360,000 people could be affected by the overall set of changes, according to a figure cited by Governor Maura Healey when she announced a statewide public information campaign.
For this reason, on August 11, 2026, the Healey administration launched a $10 million statewide campaign in partnership with Health Care For All and 47 community organizations.
The goal is to inform residents through flyers in nine languages, social media advertisements, and ads at MBTA stations.
According to Healey, people who could be affected by the new work requirements include:
- Delivery workers
- Home care aides
- College students
- People with low incomes who currently qualify for MassHealth
An analysis by Health Care For All, cited by the Boston Globe, estimates that more than 200,000 Massachusetts residents could lose their coverage by 2028 because of these requirements.
MassHealth’s own projection is around 175,000 people.
MassHealth, Massachusetts’ Medicaid program, is already working to identify and directly notify people who may be affected.
Even so, the agency’s recommendation is clear: all members should make sure their contact information is up to date.
They should also pay close attention to any letter that arrives in a blue envelope, the visual signal MassHealth uses for renewal notices.
The Three Main Changes
1. New Work and Education Requirements — Starting January 2027
Some adults ages 19 to 64 will have to show that they work, attend school, participate in a job training program, or perform volunteer work for at least 80 hours per month in order to maintain their coverage.
This may include unpaid work, volunteering with a nonprofit organization, or being enrolled at least half-time in high school, a GED program, a community college, or a university.
This requirement does NOT apply to everyone. Exemptions include, among others, people who:
- Are pregnant or within 12 months after giving birth.
- Are parents, guardians, or primary caregivers of a child under age 14 or a person with a disability.
- Have Medicare (Part A or Part B).
- Have a disability, serious medical condition such as cancer or heart failure, serious mental health condition, or substance use disorder that makes it difficult to work.
- Are under age 26 and had Medicaid when they aged out of the foster care system.
- Are veterans with a total disability recognized by the Department of Veterans Affairs (VA).
MassHealth offers a short online questionnaire to help people determine whether these requirements may apply to them.
2. Renewals Every 6 Months Instead of Every 12 Months — Starting January 2027
Some low-income adults ages 19 to 64 without a disability will have to renew their MassHealth coverage every six months instead of once a year.
People who are pregnant, recently postpartum, or have a disability generally will not be subject to these more frequent renewals.
In some cases, MassHealth may renew coverage automatically, without the member having to take any action. If it cannot renew coverage automatically, it will send a renewal notice in a blue envelope.
3. Eligibility Changes for Certain Immigrants — Starting October 1, 2026
Under the new federal law, some immigrants who are lawfully present in the United States will no longer qualify for comprehensive Medicaid coverage.
MassHealth estimates that approximately 7,300 members in the state will be affected.
Groups that could be affected include:
- People who arrived as refugees
- People who were granted asylum
- People with humanitarian parole
- Survivors of abuse or trafficking whose immigration status was derived from that situation
- Noncitizen veterans
- Certain categories of Iraqi, Afghan, Ukrainian, and Amerasian immigrants, among others
It is important to clarify who will NOT be affected by this specific change, even if they belong to one of these groups:
- Lawful permanent residents (Green Card holders)
- Cuban and Haitian entrants
- People from Micronesia, the Marshall Islands, and Palau under the Compact of Free Association (COFA)
- People under age 21
- People who are pregnant or within 12 months after giving birth
People who are affected will not lose all health coverage. Instead, they will move to another type of MassHealth coverage.
- People age 65 or older, or people with a disability, will generally move to MassHealth Family Assistance.
- People ages 21 to 64 without a disability will generally move to MassHealth Limited and/or the Health Safety Net, which primarily cover emergency services.
Two Additional Changes Coming Later
Starting in January 2027, MassHealth’s retroactive coverage—the period during which coverage can be applied backward before the application date—will be reduced to one month for adults who qualify under the MassHealth expansion criteria.
For other members, it will be reduced to two months.
Starting in October 2028, adults with incomes above 100% of the federal poverty level will have to meet new copayment requirements.
MassHealth has not yet published the amounts or operational details of this measure. More federal guidance is expected in the coming months.
How Can I Protect My Family’s Coverage?
MassHealth emphasizes three concrete actions that every family can take today, even if they do not yet know whether the changes apply to them:
- Update your contact information: Make sure MassHealth has your current cellphone number, mailing address, and email address so the agency can reach you.
- Read and respond to any letter or message from MassHealth, especially those that arrive in a blue envelope.
- Report important changes right away: This includes a new pregnancy, a disability, a change in income, or a change in household size.
MassHealth also offers an online questionnaire, available in several languages including Spanish, to help each person determine whether any of these changes could directly affect them.
Frequently Asked Questions About the MassHealth Changes
Will I lose my MassHealth coverage?
Most members will not be affected.
The changes primarily affect adults ages 19 to 64 without disabilities, without young children in their care, and certain groups of immigrants.
If you have questions about your situation, MassHealth offers an online questionnaire in Spanish to help determine whether the changes apply to you.
What if I am pregnant or recently had a baby?
You are exempt from the new work requirements and the six-month renewal requirement if you are pregnant or within 12 months after giving birth, regardless of the outcome of the pregnancy.
Do I need to do anything right now?
Yes. One very simple step is to confirm that MassHealth has your current cellphone number, mailing address, and email address.
This will help ensure that MassHealth can contact you directly if something changes for you.
How will I know if I have to meet a new requirement?
MassHealth will contact you directly by letter, text message, email, or phone call.
The most important signal to watch for is a blue envelope. If you receive one, open it and respond before the deadline.
Do these changes affect my children?
No. Children under age 21 are not subject to these new requirements or the immigration eligibility changes.
If I am an immigrant, will I lose all of my health coverage?
Not necessarily.
If your immigration category is affected by the October 2026 change, you will move to another type of MassHealth coverage—Family Assistance, or Limited/Health Safety Net for emergency services.
You will not necessarily be left without any coverage option.
Where can I get help if I don’t understand my situation?
You can call MassHealth at 1-800-841-2900 (TTY: 711) or contact Health Care For All, which is working with the state to help members navigate these changes.
Massachusetts Resources
MassHealth
Member Service Center: 1-800-841-2900 (TTY: 711), Monday through Friday.
Federal changes affecting MassHealth members:
mass.gov/federal-changes-affecting-masshealth-medicaid-members
Work and education requirements:
mass.gov/info-details/new-work-and-education-requirements-for-masshealth-members
More frequent renewals:
mass.gov/info-details/more-frequent-renewals-for-masshealth-members
Information for noncitizens:
mass.gov/info-details/masshealth-information-for-noncitizens
Materials and flyers to share:
mass.gov/lists/member-facing-materials-for-masshealth-federal-changes
MyServices:
mass.gov/learn-about-myservices
How to report changes:
mass.gov/how-to/report-changes-to-masshealth
Online questionnaire
MassHealth offers a questionnaire to help members determine whether the federal changes may affect them. It is available in Spanish and other languages.
Visit Mass.gov and search for “Federal changes affecting MassHealth members.”
MyServices
MyServices is MassHealth’s online platform, available 24/7, where members can report changes, check their coverage status, and update their contact information.
MassHealth also provides informational flyers in Spanish, Brazilian Portuguese, Haitian Creole, Vietnamese, Khmer, Simplified Chinese, Arabic, and Cape Verdean Creole that can be shared with communities, churches, and organizations.
Health Care For All
Health Care For All is a partner organization in the state’s public information campaign. It offers a free help line and multilingual guides to help people navigate these changes.
This article summarizes information published by MassHealth (the Massachusetts Executive Office of Health and Human Services), as well as reporting from WBUR and the Boston Globe about the state’s public information campaign.
My Health Fair shares this information with the Latino community in Massachusetts as part of its commitment to making health information that directly affects families accessible in Spanish throughout the year.
Fuente: Mass.gov — MassHealth (Executive Office of Health and Human Services), WBUR (11 de agosto, 2026), Boston Globe vía Health Care For All (27 de marzo, 2026).
Sources: Mass.gov — MassHealth (Executive Office of Health and Human Services), WBUR (August 11, 2026), Boston Globe via Health Care For All (March 27, 2026).
