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FOR MOST PEOPLE in Massachusetts who receive health insurance from their employers, Medicaid is not top of mind. But the fact is that MassHealth, as Medicaid is called in our state, provides coverage to over 1 in 4 of our residents. Because of this, the program plays a vital role in our state’s health care system and the strength of our economy.

If you think about the wide range of people who depend on MassHealth, chances are that someone in your life has relied on it at some point in their life.

It could be the woman working as a cashier at a local business who can get prenatal care to give her baby the best chance at a healthy start in life, or your friend’s child with autism receiving the support services they need to reach their full potential.

It may be a recent high school graduate who is pursuing higher education and job training to advance their career without the fear of losing insurance coverage, or your neighbors working in low-wage sectors who want to provide health security for their families. Or it could be relatives who are elderly or living with a disability who have services and supports that help them stay in their home instead of going to a care facility.

Despite its importance, Medicaid is now squarely on the chopping block. On Thursday, the US House of Representatives passed its so-called “Big, Beautiful Bill,” a legislative package that includes nearly $700 billion in reduced federal spending on Medicaid that would significantly reduce funding to states and result in major losses in health coverage. The measure, designed to offset the cost of tax cuts proposed by the new administration, moves on to the Senate.

It is crucial that we understand the major role MassHealth plays in ensuring that all residents of Massachusetts have access to health care, as well as the devastating impact federal cuts to the program would have on individuals and families (our friends and neighbors), doctors, home care services, nursing homes and hospitals – and the state’s economy.

In Massachusetts, over 2 million people receive their health insurance through MassHealth. It provides coverage to two-thirds of people with low incomes (below 133 percent of the federal poverty level; about $20,800 annually for a one-person household in 2024).

In contrast to common perception, over 75 percent of people covered by MassHealth under age 65 live in working families. Each year, MassHealth provides health insurance to hundreds of thousands of low-income workers who could not otherwise afford coverage, working in sectors such as food services, transportation, retail sales, cleaning, and construction.

MassHealth covers residents across the lifespan, including almost 40 percent of all births in Massachusetts, 48 percent of children and young people up to age 20, almost 60 percent of people with disabilities, and 70 percent of residents in nursing homes.

Because MassHealth funds are central to the financial support of our health care system, the impacts of cuts could threaten access for all of us. MassHealth funds account for over 50 percent of patient revenue for nursing homes and more than 45 percent of funding for community health centers and long-term services and supports (such as home health care and personal care assistants). Approximately 18 percent of all of hospital patient revenue comes from the MassHealth program.

In addition to the direct and indirect hit on our economy, it is important to note that 86 percent of all federal revenue in our current state budget is generated by federal Medicaid reimbursement. That reimbursement totals more than $12 billion annually, covering half of the cost of the MassHealth program.

Major federal Medicaid cuts could shift hundreds of millions of dollars in costs onto the Commonwealth and would make it more difficult, if not impossible, for our state to sustain the high coverage rates that MassHealth has made possible.

It’s hard to overstate the harm posed by potential cuts to Medicaid. Even for those of us who do not use the program for our health insurance, it is important to recognize that, whether we know it or not, people in our lives and with whom we interact every day rely on Medicaid. Cuts would reduce funding for the health care system that our families use. And such cuts would harm the economy and competitiveness of Massachusetts.

This is too big a threat to stay silent about. We can work with the federal government to continue to make improvements in the effectiveness and efficiency of Medicaid. There is no mistaking, however, that we all need to defend the funding of this critical program.

Audrey Shelto is president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.