Ohio budget goes to Dewine for final approval, Medicaid ‘trigger language’ still included

Ohio lawmakers approved a two-year budget this week after days of closed-door negotiations (Source: “Ohio state budget now up to Gov. Mike DeWine. What's in it?,” Columbus Dispatch, June 25).

The budget now heads to Gov. Mike DeWine, who must sign it before July 1. DeWine can also veto individual items he doesn't support.

The budget would automatically end Medicaid expansion coverage if the federal match falls below 90%, something DeWine and GOP lawmakers all support. It also doesn't allow Medicaid to pay for gender-affirming mental health care or diversity, equity and inclusion initiatives.

Data and projections included in HPIO’s recently completed 2025 Ohio Medicaid Expansion Study show that eliminating Medicaid expansion would lead to a projected 80% increase in the number of Ohioans who are uninsured. Ending expansion would also mean that Ohio would lose more than $1 billion a year in federal funds that are used to pay for mental health and substance use treatment, among other negative economic outcomes for the state.

Even if the complete elimination of Medicaid expansion does not occur, other changes under consideration at the state and federal levels could impact coverage and funding for services.

HPIO’s 2025 Ohio Medicaid Expansion Study includes a series of five reports examining various facets of the issue, including Access to mental health and substance use disorder treatment, parents, caregivers and their children, the state budget, health insurance coverage and cost and jobs and the economy.

HPIO’s 2025 Ohio Medicaid Basics and Policy Considerations: The Future of Group VIII (expansion) Medicaid Coverage in Ohio brief contain more general information on the Medicaid program overall and considerations about Medicaid expansion coverage as policymakers consider the program's future.