Massachusetts could see major Medicaid cuts this year due to reductions in federal spending.
The legislation known as One Big, Beautiful Bill aims to cut billions from MassHealth, the state’s Medicaid program and children’s health insurance program, which covers nearly 2 million residents.
According to the Healey administration, the proposed cuts could reduce services at nursing homes, community health centers and hospitals — potentially leading to permanent closures and job losses among health care workers.
Dr. Damian Archer, CEO of Outer Cape Health Services, said his organization is preparing for the changes.
“We have not had any direct cuts. At the same time, we are concerned about what may be coming down the pike because of the passage of one big, beautiful bill and other federal policy changes that are happening," Archer said. "We are trying to figure out if they will impact us significantly enough to cause a decrease in revenue or the ability to provide services.”
At OCHS, the programs facing the most risk are in social services, Archer said.
“From an operating business perspective, our supportive social services are at significant risk when there are income challenges because most of those services are not compensated for at the rate that it costs to provide them.”
He continued, “Those services in general are at greatest risk at all health centers that are mandated to provide social supportive services in addition to medical care.”
Recruiting new staff has also been difficult with financial operations under threat.
“When anyone has a reason to be concerned about the ongoing financial sustainability of an organization… and for folks that aren’t already embedded in the community, it is a harder sell for somebody to consider moving to a place like this for work,” Archer said.
Archer emphasized the importance of considering the long-term impact of federal funding cuts on rural health programs.
“It is harmful when people’s access to healthcare, particularly, primary care, which is almost always focused on prevention of illness, and the reduction of cost to treat for that illness is threatened,” he said.
Archer said the proposed reductions could inadvertently increase the overall cost of care in affected communities.
“It’s best when we are able to see as many patients as possible and provide those services with as low barriers as possible,” Archer said.
“The mandate of community health centers is to provide our services regardless of an individual’s ability to pay," he continued. "In many instances, the presence of community health centers and the expansion of community health centers helps to reduce the use of emergency rooms and in general does impact the cost of care in a positive way.”
The legislation also proposes to impose work requirements for non-disabled adults, ban Medicaid funds from being used by providers primarily engaged in family planning or reproductive services, and prohibit federal matching funds for gender transition procedures.
“Community health centers require there to be support from the community. That includes local town representatives, state representatives, and those at the federal level. People need to resonate with how important it is to ensure that access to preventive care and primary care is available to everyone,” he said.
According to The Commonwealth Fund, Massachusetts is projected to lose approximately $1.97 billion in Medicaid funding by 2029. State officials estimate total yearly cuts to federal health care funding could reach $3.5 billion.
“This requires folks to speak up loudly,” Archer said.
