By Lindsay Antaya
If you are a working Massachusetts resident with employer-based health insurance, you might wrongly assume that the Medicaid and food assistance cuts in the recently passed One Big Beautiful Bill Act (OBBBA) don’t affect you. These programs may not serve you directly, but they help stabilize the broader systems that your family, coworkers, and neighbors depend on.
Even if you don’t receive Medicaid or rely on government-funded food assistance, you and your community will likely feel the effects of OBBBA.
Hospitals Will Be the First to Feel the Strain
To understand how entire communities will be affected, we first need to look at how this legislation will impact Massachusetts hospitals. According to the Congressional Budget Office, nearly five percent of the Commonwealth’s population could lose insurance coverage under the bill, largely due to new work requirements and increased eligibility checks that create administrative hurdles for individuals trying to stay enrolled.
Healthcare leaders and state officials have raised concerns about the pressure this will place on hospitals, particularly those in the state’s Health Safety Net – the fund that helps hospitals cover the cost of care for patients without insurance or with limited coverage.
When individuals lose insurance, they often delay or forgo preventive care and turn to emergency departments for issues that could have been addressed in a primary care setting. This creates longer hospital wait times for everyone and increases the burden of uncompensated care.
The Health Safety Net is already consistently underfunded, with an estimated shortfall of over $250 million in fiscal year 2025. Any shortfall must be absorbed by hospitals alone, and OBBBA will only increase the financial pressure, jeopardizing care access and stability in communities across the state. In response, the Healey-Driscoll administration has initiated efforts to track how federal actions are affecting organizations across Massachusetts and help shape the state’s long-term strategy to protect patients and providers.
Fewer Resources Could Mean Fewer Services for Everyone
Financial strain from uncompensated care is just one piece of the challenge facing hospitals. In the aftermath of COVID-19, providers are navigating workforce shortages, capacity issues, and a sicker patient population due to delayed care.
To manage these growing pressures, hospitals may be forced to reduce labor costs or scale back less profitable services. Hospitals could also have to limit purchases from local vendors – that could mean ending contracts with a neighborhood bakery that supplies food for patient meals or pulling back on printing services from a nearby small business. These are actions that affect not only the quality of care but also jobs and local economies.
Some providers may also look to commercial insurers to offset losses, which could mean higher premiums and out-of-pocket costs for people with employer-based coverage. These ripple effects will drive up healthcare costs and make accessing timely care harder for everyone, even those who have never relied on Medicaid.
SNAP Cuts Further Put Health and Families at Risk
Many families who will lose Medicaid coverage could also lose Supplemental Nutrition Assistance Program (SNAP) benefits due to overlapping work and eligibility requirements. SNAP is a critical program that helps low-income families access nutritious food that is essential to their health and well-being.
Data shows that food insecurity can affect any household and touches every Massachusetts community – according to the Greater Boston Food Bank, over a third of Massachusetts households faced food insecurity in 2024. 16 percent of the state’s population – one in six individuals – rely on SNAP benefits to buy groceries and help put food on the table, and more than 50 percent of SNAP participants are in families with children.
Food insecurity worsens chronic disease, delays childhood development, and leads to more hospitalizations. In July, a Senior Fellow at the University of Pennsylvania’s Leonard Davis Institute of Health Economics and a New York University researcher submitted a memo to House Speaker Mike Johnson and Senate Majority Leader John Thune estimating that OBBBA’s SNAP cuts could result in 93,000 premature deaths nationwide by 2039.
In Massachusetts, lawmakers are also warning of the broader economic fallout from reduced SNAP benefits. Governor Healey recently established an Anti-Hunger Task Force to help the Commonwealth respond, citing concerns that these changes will harm not only families, but also local food retailers, farmers, and small businesses. Every dollar spent on SNAP generates $1.54 in benefits for local economies – cuts of this magnitude will undermine community food systems and erode economic stability.
Moving Forward with the One Big Beautiful Bill Act
When Medicaid and SNAP are slashed, not only does our healthcare ecosystem and local economy take a direct hit, but families across the state lose their ability to stay healthy and nourished. You don’t have to rely on public benefits to feel the negative impact of OBBBA’s policies. If you pay for insurance, shop at a local grocery store, or rely on your community hospital, this bill impacts you.