INTRODUCTION: Massachusetts Medicaid (MassHealth) transitioned a Section 1115 waiver-based housing support program to a permanent program in 2025, implementing new eligibility restrictions.
METHODS: We projected the potential impact of these new eligibility restrictions using linked administrative claims and programmatic data.
RESULTS: Among individuals enrolled from 2021 to 2024, 68% would no longer qualify under updated 2025 criteria. Those projected to remain eligible were older and had more chronic conditions and higher healthcare utilization than those projected to be ineligible, but similar prevalence of opioid use disorder and mental illness.
CONCLUSION: These findings highlight the potential for unintended consequences in eligibility prioritization stemming from operational shifts in Medicaid waiver-based programs.
McCann NC, Hsu HE, Ettinger de Cuba S, et al. When state medicaid demonstrations end: projected eligibility loss after a masshealth housing support program transition. Health Aff Sch. 2025;3(11):qxaf213. DOI:10.1093/haschl/qxaf213. PMID: 41267910
University of San Francisco California