Budget cuts at the federal and state level have the potential to raise the uninsured rate in Ohio and put health coverage in jeopardy for a large part of the state.
More than 25% of the state’s population is covered by Medicaid, according to a study of federal and state data conducted by the Center for Community Solutions, based in Ohio.
According to the center, one in five working-age adults, one in ten adults 65 and older, and two out of five children in Ohio are covered by Medicaid.
Families and children account for 53.2% of the state’s Medicaid caseload, making them the largest group. The Medicaid expansion covers 25.5% of the cases. The blind and disabled, as well as older Ohioans, account for 16.6% of the caseload.
According to state data, Ohio’s uninsured rate has decreased by half since Medicaid expansion. The Medicaid expansion “has been a major contributor to Ohio’s uninsured rate dropping by half from 14% in 2010 to 7% in 2022,” according to the Health Policy Institute of Ohio.
According to the Center for Community Solutions study on Medicaid, “early diagnosis and treatment of conditions reduces the need for expensive ER visits, lengthy hospital stays, and additional public spending.”
The center discovered that 769,520 Ohioans are enrolled in Medicaid expansion, with nearly half of them working in the state. Other Medicaid expansion participants are “students, caretakers, or dealing with a chronic health condition.”
This is significant because the Trump administration and Congress are considering Medicaid cuts as part of their plans to reduce federal spending in general, as well as changes to the program’s work requirements.
Ohio is exploring its own cost-cutting strategies, such as a clause in the House version of the budget that would result in Medicaid cuts in Ohio if the federal government were to decrease its funding of the state’s Medicaid coffers.
If the federal government stops funding 90% of the Medicaid expansion, Group VIII—the group included in the expansion—would be eliminated in the budget proposals from the Ohio House and Governor Mike DeWine.
Medicaid supporters and advocates worry that as part of the ongoing budget reconciliation process in Washington, D.C., $880 billion may be taken away from Medicaid. According to them, that would have disastrous effects on low-income communities and those who are most in need of assistance.
KFF health policy researchers estimate that federal cuts of $880 billion over the next ten years would account for 29% of program spending per resident. According to them, the federal cuts “amount to all Medicaid spending on 22 million Medicaid-enrolled children, 14 million other adults, and 3 million seniors and people with disabilities.”
72 million people nationwide are enrolled in Medicaid, with a large number of them living in Republican-led states like Louisiana, the home state of U.S. House Speaker Mike Johnson, and West Virginia. According to Johnson, the program wastes billions of dollars every year due to fraud, abuse, and waste.
The USC Center for Health Journalism hosted a panel discussion where Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy, talked about the cuts. According to Park, over one-third of Medicaid enrollment is made up of children, and 40% of all births in the nation are covered by Medicaid.
Medicaid cuts at the federal level would require cuts at the state level because states, unlike the federal government, must balance their budgets.
“States would not be able to sustain their current Medicaid programs as is over the long run due to these very large cuts,” Park stated.
Park said states could reduce Medicaid programs to make up for a loss of federal funding. They could also reduce other budgetary allocations, which would probably include funding for education as it is one of the most costly programs. Or states could drastically increase taxes.
According to Park, states would likely begin by reducing optional Medicaid services like dental and vision coverage before attempting to secure waivers for specific Medicaid components like prescription coverage.
770,000 Ohioans would lose their coverage if Ohio’s Medicaid expansion group were to disappear. This group consists of people aged 19 to 64 who do not qualify for other Medicaid coverage and whose household income is less than 138% of the federal poverty level. That comes out to about $44,000 for a family of four.
Southeast Ohio and rural counties, such as Allen County, where House Speaker Matt Huffman resides, have high Medicaid enrollment rates, with 28% of the population covered by Medicaid.
Before the deadline of July 1, the Senate is finalizing its budget. In March of this year, Medicaid covered 15 percent of Henry County, where Senate President Rob McColley resides.
With 42% of the population enrolled in traditional Medicaid and 10% in the Medicaid expansion group, Pike County had the highest Medicaid rate in the state last month. In nearby Scioto County, 12% of the population was enrolled in Medicaid, and 41% of the population was enrolled.
According to state data and an analysis by the Center for Community Solutions, the rates in Clark, Adams, Lawrence, and Gallia counties were similarly high, exceeding 30% for traditional Medicaid and ranging from 8% to 11% for the expansion group.
