Data Graphics

HR 1, the federal reconciliation bill (sometimes referred to as the “One Big Beautiful Bill Act”) that passed Congress over the summer, includes a requirement that states impose cost sharing of up to $35 per service for some Medicaid expansion enrollees.

As illustrated above, Ohioans who are enrolled in Medicaid are more likely to report difficulty paying household costs, such as food, housing and medical expenses, than those with other forms of insurance or those who are uninsured.

The new cost-sharing requirement is set to go in effect on Oct. 1, 2028, and includes co-pays, co-insurance and deductibles. The requirement will apply to all Medicaid enrollees earning between 100% and 138% of the federal poverty level ($32,150 to $42,759.50 for a family of fourin 2025).

Primary care, mental health and substance use disorder services will be excluded from the cost-sharing requirement, as will services provided by federally qualified health centers, behavioral health clinics and rural health centers.

HPIO has developed a series of publications to explore the healthcare access and affordability impacts of recent policy changes, such as HR 1 and the state’s biennial budget bill.

The percent of Ohioans with a credit report that includes medical debt dropped by nearly 40% from 2011 to 2022, although the percent remains higher than the U.S. overall, as illustrated above.

The decline in medical debt coincides with a drop in Ohio’s uninsured rate, which has been halved following the passage of the Affordable Care Act in 2010 and Ohio’s decision to expand Medicaid eligibility beginning in 2014.

A bipartisan bill under committee review in the Ohio House aims to curb aggressive medical debt collection practices.

House Bill 257 would end the ability of hospitals to garnish wages and would reduce (from 8% to 3%) the legal interest rate that runs on collection judgments. The legislation also would prohibit healthcare providers from reporting unpaid medical debts to credit reporting agencies. Bad credit scores can limit access to loans and raise costs for borrowers. The nation’s three largest credit bureaus voluntarily stopped reporting medical debt of less than $500 in 2023.

In recent media interviews, the sponsors – Rep. Jean Schmidt, a Cincinnati-area Republican, and Rep. Michele Grim, a Toledo Democrat – said medical debt isn’t like a car loan or credit card debt. Injuries and illnesses are usually unplanned, and patients have little ability to price shop or weigh pros and cons before executing what are oftenexpensive costs for health needs.

Maine, Colorado, Oregon, Vermont and others have recently passed legislation to prohibit providers from reporting medical debt to the credit agencies.

A recently released HPIO data snapshot provides a series of data graphics that illustrate the challenges Ohio immigrants face in accessing health care,

The publication gives an overview of the demographics of immigrants in Ohio, factors that hinder healthcare access, Medicaid eligibility, uninsured rates (as illustrated above) and potential impacts of recent federal policy change.

"These challenges limit access to preventive care, treatment and insurance coverage," according to the snapshot. "Recent federal and state policy changes are likely to further reduce healthcare access for Ohioans who are immigrants."

The data brief is the third in a series of HPIO publications that includes data and analysis about the current challenges facing working Ohioans, and examines how recent federal and state policy changes will impact access to care and affordability in Ohio.

The Health Policy Institute of Ohio has released a new quick, high-level policy explainer of potential Medicaid work requirements in Ohio.

The publication details Medicaid work requirements recently established by federal law through HR 1, the federal reconciliation bill that is sometimes referred to as the “One Big Beautiful Bill Act,” and the work requirements proposed by Ohio policymakers through an 1115 waiver proposal submitted in February 2025.

The publication describes the potential impacts of Medicaid work requirements, key points in the implementation timeline and upcoming decisions for state policymakers.

The implementation of work requirements will occur over the next few years, as illustrated above, and will be impacted by upcoming regulatory decisions from the federal Centers for Medicare and Medicaid Services. Additionally, Ohio policymakers will need to make important decisions related to work requirements in the state, including potentially reconciling the submitted 1115 waiver with the requirements in HR 1. [BO1] [NW2]

The data brief is the latest in a series of HPIO publications that includes data and analysis about the current challenges facing working Ohioans and examines how recent federal and state policy changes will impact access to care and affordability in Ohio.

HPIO’s 2025 Health Policy Summit, which will take place on Thursday, Oct. 9, will feature a plenary session focused on the health policy impacts of HR1. The session will feature:

• Jennifer Tolbert, MPH, MSW, Director of State Health Policy and Data and Deputy Director Program on Medicaid & Uninsured, KFF
• Adam Searing, JD, MPH, Associate Professor, Georgetown University McCourt School of Public Policy, Center for Children and Families

Click here for more information about the Summit and to register (the deadline for registering is Thursday, Oct. 3).

September is Suicide Prevention Month and data shows that suicide death rates have increased for all age groups since 2007, with Ohioans ages 25-64 remaining the most likely to die by suicide, as illustrated above.

In Ohio, approximately five people die by suicide every day, according to data included in the Suicide Prevention Plan for Ohio. These preventable deaths have a tremendous impact on Ohio families and communities. With the rate of suicide climbing over the past decade, both in Ohio and nationally, there are evidence-informed strategies that public- and private-sector leaders can implement to address the issue.

Last year, HPIO released a data snapshot that includes visualizations on suicide prevalence and trends in Ohio, geographic differences in suicide rates and changes in mental health challenges among Ohio high school students. It also includes a list of resources to improve suicide prevention in Ohio.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org 24/7 for free and confidential support.

The Health Policy Institute of Ohio has released a new data brief titled Healthcare Affordability Challenges for Working Ohioans that presents current data on the cost of basic needs for working Ohioans, access to adequate health insurance and the cost of health care for Ohio families.

“Many Ohio families are facing significant cost of living challenges, of which healthcare expenses are an increasingly pressing problem,” according to the brief. “While having adequate health insurance is important, individuals with all coverage types may face large medical bills, leading to difficult financial decisions. When individuals forgo care due to cost, it can lead to even larger expenditures later in life, including expensive emergency department visits and inpatient hospitalizations.”

Recent state and federal policy changes are likely to be consequential for health care affordability in Ohio, especially among people enrolled in Medicaid and Federal Health Insurance Marketplace plans (see HPIO’s recently released fact sheet on state and federal policy changes). Given the high healthcare costs and challenging situations that many Ohio families already face, policy changes impacting insurance access and out-of-pocket spending may continue to exacerbate financial insecurity and disparities across different communities.

The data brief is the second in a planned series of HPIO publications that includes data and analysis about the current challenges facing working Ohioans and examines how recent federal and state policy changes will impact access to care and affordability in Ohio.