HPIO Releases Final Briefs in 5-Part Ohio Medicaid Expansion Study

HPIO has partnered with subject matter experts and two national research organizations, Urban Institute – to conduct state budget impact modeling and Regional Economic Partners – to undertake economic modeling, to describe how the 2014 expansion of Medicaid in Ohio has impacted coverage, access, and affordability of healthcare; and to estimate the future impacts if Medicaid Expansion is discontinued in the future.  You can read a 4-page summary of all five briefs here.

Briefs in the series explored:

• The State of Ohio Budget
• Jobs & The Economy
• Health Insurance Coverage & Costs
• Parents, Caregivers, & their Children
• Access to Mental Health & Substance Use Disorder Treatment

Key findings from the Medicaid Expansion & State Budget Report:

• Costs, Revenue, & Savings: While the state currently pays 10% of Medicaid expansion costs, expansion generates state revenue and produces state savings, resulting in an effective state share of 1.4%.
• Revenue from Economic Activity: Medicaid expansion is projected to generate over $1.1 billion over the next 5 years in state general revenue from personal income taxes, sales taxes, and gross receipts taxes.
• Net Savings: Discontinuing expansion would save substantially less than the state share amount, it would reduce federal funds coming to Ohio by over $42 billion over 5 years, and would leave an estimated 435,000 Ohioans without coverage.

Key findings from the Jobs & The Economy Report:

• Eliminating expansion would slow job growth by more than 50,000 in Ohio, compared to if Medicaid expansion remained intact over the next 5 years: 45% of job losses would be in healthcare and 55% would be across other sectors, including construction, administrative, and restaurant.
• Ohioans would see $4.7 billion decline in personal income growth: Household personal income would reduce on average $900 per household.
• Eliminating Medicaid expansion would slow state tax revenue by $220.6 million: More than 25% would come from income tax losses and remaining 75% from sales and commercial activity taxes.

Key findings from the Healthcare Coverage & Costs Report:

• Ohio’s uninsured rate would increase: Estimates suggest uninsured rates could increase by 80% in 2026.
• Low-income Ohioans have limited access to employer-sponsored insurance: 66% of low-wage workers would be ineligible for employer-sponsored health insurance and would become uninsured.
• Ohio households, employers, and providers would spend more on acute care.

Key findings from the Parents, Caregivers, & Children Report:

• Children’s uninsured rate decreased from 7.5% in 2013 to 6.5% in 2023 after Medicaid expansion.
• Health & well-being are supported.
• Women are connected to needed care before pregnancy.

Key findings from the Mental Health (MH) & Substance Use Disorder (SUD) Treatment Report:

• High Demand: 45% of adults covered by expansion had a primary MH or SUD diagnosis in 2024.
• Significant Investments: Ohio received more than $1 billion in federal funds for community-based and hospital BH services for expansion enrollees in 2024.
• Potential Risk: If expansion was discontinued, many Ohioans would lose access to treatment.