Ohio’s Budget Could Boot 771,000 From Medicaid Pending Federal Budget Cuts

A swirl of possible state and federal policy decisions could eject 771,000 Ohioans from Medicaid, a public health insurance program for low-income earners.

Those people are covered today thanks to Ohio’s 2013 decision via Gov. John Kasich to extend Medicaid to those earning up to 138% of the federal poverty line.

For a family of four, that’s about $44,000 per year. Previously, Medicaid was generally limited to children, pregnant women, or people with disabilities, all from low-income households.

At the time Ohio expanded its Medicaid coverage the federal government covered 100% of the expansion. That was reduced gradually from 2016 to 2020 to its current 90-10 split between the federal and state government.

Under current law, the state can already end coverage of the expansion population if there’s a federal funds reduction. The proposed budget language, however, would make this mandatory.

Medicaid Overhaul Proves to be Politically Perilous Proposition

In their quest to pay for President Donald Trump’s policy priorities, Republicans are eyeing Medicaid, the largest health insurance program for more than 70 million low-income Americans, as a program ripe for cuts. But they face obstacles that could block any sort of overhaul to the nearly 60-year-old joint state and federal program. Among those obstacles: public opinion, members of their own party in competitive districts, governors who worry about impacts to their state budgets, a closely divided Senate, and maybe one of the most formidable: hospitals and health care providers that carry significant influence in Washington. While House Republicans and some governors are coalescing around “work requirements” in Medicaid as a way to save money, more significant cuts — and more politically perilous ones — remain on the table. One of the most impactful policies would be reducing how much the federal government spends to cover the Medicaid expansion population. And several states have already indicated they will pursue work requirements, including Ohio, Arkansas and South Carolina.

Implementation Fact Sheet - Three Key Steps to Implement the Requirements of 2024 Part 2 Final Rule

On February 16, 2024, HHS released a Final Rule updating 42 CFR Part 2, the federal regulations governing the confidentiality of substance use disorder (SUD) treatment records. The Final Rule implemented changes required by Congress in the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act to align certain aspects of 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. This Fact Sheet is intended to assist Part 2 programs in complying with the requirements of the Final Rule by describing in detail 3 key steps that programs can take to support implementation.

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