Massachusetts Disability Panel Warned of $3.5 Billion Medicaid Funding Loss Through 2028

BOSTON — January 26, 2026 — Massachusetts disability subcommittee hears warning of $3.5 billion Medicaid loss and imminent service restructuring. The Long-Term Services and Support and Health Equity Subcommittee of the Massachusetts Commission on the Status of Persons with Disabilities met January 26 and received a briefing from Leslie Darcy, Chief of Long-Term Services and Supports at MassHealth, on federal funding changes expected to cost the Commonwealth approximately $3.5 billion in aggregate through 2028. Darcy reported that the state's legislatively mandated PCA working group finalized recommendations yielding an estimated $32 million in savings, including a reduction in the PCA overtime cap from 66 to 60 hours — effective no sooner than July 1, 2026 — and a seven-hour weekly ceiling on meal prep support. The $22 billion MassHealth program is growing at roughly 12 percent annually, and Darcy described the fiscal year 2027 budget as containing only "targeted" initial cuts, with harder decisions deferred to 2028. The health safety net for uncompensated care is already underfunded by roughly $300 million this year, and Darcy warned that federal changes reducing insurance coverage will deepen that gap. Commission member Charlie Carr noted the PCA working group's $32 million in savings was "a drop in the bucket" given the scale of the challenge but said the process modeled how future reductions across LTSS should be developed.