In July 2025, Congress enacted H.R. 1, also known as the “One Big Beautiful Bill” Act (OB3), which is a major tax and domestic policy law that will ultimately impact health care coverage in Massachusetts through significant changes to federal law.  

This chart pack provides an overview of the public coverage programs in Massachusetts that will be affected by OB3, explains the key provisions in the law that will change Medicaid and Marketplace eligibility and financing, and elevates what we know about how these provisions will impact the coverage landscape and the broader health care delivery system in Massachusetts.

The data presented in this chart pack are derived from previous Foundation publications, as well as other publicly available sources.

MassHealth provides health care services to around 2 million Massachusetts residents, brings in significant federal revenue, and serves as a driver of health system reform. In light of recent changes to federal Medicaid law that will soon impact program coverage and financing, it is critical that stakeholders understand the importance of MassHealth and its role in the state’s broader health insurance and delivery system landscape.  

This resource highlights key facts about MassHealth, including the many ways in which the program contributes to the Massachusetts economy and promotes health care coverage and access for residents in the state.