OB3 (the 2025 major federal tax and policy law known as the One Big Beautiful Bill) will affect MassHealth through implementing work requirements, more frequent renewals, and changes to immigrant eligibility.
Work and Education Requirements
MassHealth, federally known as Medicaid, is implementing work and education requirements starting January 1, 2027. These changes are due to impacts from OB3 and are distinct from the work requirements for SNAP. MassHealth members should review MassHealth’s screening tool to understand how they are affected. MassHealth can assist in ensuring members are meeting work requirements.
These new federal work and education requirements will primarily impact adults who are 19 through 64 years old AND do not have young children, or a disability/medical condition.
Affected members will need to meet these requirements or prove they are exempt.
Members should review all of the exemptions and ensure they are either exempt or meeting work and education requirements in December 2026, or they will not be eligible for enrollment January 1, 2027.
Any members who will be affected by these changes will be contacted by MassHealth directly. All members should make sure that MassHealth has their current cell number, mailing address, and email, and respond to all requests from MassHealth as soon as it is received.
More Frequent Renewals
If a member is not exempt from the work requirements, they will need to renew their eligibility every six months. More information on MassHealth’s website.
Changes to Immigrant Coverage
Starting October 2026, a limited group of non-citizens legally in the U.S. will no longer be eligible for MassHealth.
What does this mean for minimum credible coverage?
The Massachusetts Health Care Reform Law requires that most residents over 18 who can afford health insurance have coverage for the entire year or pay a penalty through their tax returns.
You’ll only be penalized for lacking insurance if you can afford to get health insurance but didn’t. See the guidelines regarding the tax penalties for not having health insurance.
Resources
- Health Care For All Helpline – a free, staffed phone line of experts who can assist with coverage questions and compare plan prices.
- Mayor’s Health Line | Boston.gov – a free, confidential, multilingual health information and referral service through the City of Boston. Available to anyone in Massachusetts.
- Get an Estimate tool – for individuals and families interested in getting an idea of the cost of plans available to them without needing to complete a full application, this tool provides cost estimates after answering just a few brief questions.
- MassHealth has appointments available by phone or in person as well as assistance online.
We are here to help constituents navigate these significant changes.
Please connect with my Constituent Services Director Regina Fink by emailing regina.fink@masenate.gov or calling/texting 857-242-1892.