The changes included strict work requirements and twice-yearly eligibility checks for adults on the state Medicaid program, called MassHealth. “It is our responsibility as a state to make sure that every single eligible individual retains coverage,” said Dr. Ryan Schwarz, assistant secretary for MassHealth, adding “Given the completely ridiculous paperwork requirements and administrative hoops that the federal administration is requiring individuals to jump through to retain their coverage, we will have fewer people on healthcare coverage in the future than we do today.” Medicaid provides coverage for about 74 million Americans with low incomes or disabilities, including 1.8 million people in Massachusetts.