Data Graphics

The Health Policy Institute of Ohio has released a new policy explainer on Rural Health Transformation Program funding in Ohio.

On Dec. 29, 2025, the Centers for Medicare and Medicaid Services announced first-year Rural Health Transformation (RHT) Program awards. Ohio will receive a total of $202,030,262, the 25th highest total amount. However, according to HPIO’s analysis, Ohio was awarded the 46th-most funding per rural resident, as illustrated above.

The RHT program was created as part of the federal reconciliation bill HR 1, sometimes referred to as the One Big Beautiful Bill Act, which was signed into law in July 2025. RHT will allocate $50 billion to states over five years, with $10 billion allocated in the first year.

Half of the first-year funding was awarded evenly among all 50 states ($100 million per state) and the other half was awarded based on state-submitted applications. The federal government scored state plans based on factors including rural population and the proportion of rural health facilities in the state, as well as states’ adoption of certain policy priorities, such as restricting the purchase of unhealthy foods and drinks with SNAP benefits, scope of practice expansion and loosening certificate of need laws.

Even after subtracting the portion of funding allocated equally to states (which inherently disadvantages larger states like Ohio), the state received the fifth-lowest amount of funding per rural resident from the application-based portion of the award.

While Ohio will receive more than $202 million in federal dollars this year through the RHT Program, the funding will not replace all of the losses to rural health funding expected due to other provisions in HR 1 ($5.6 billion for Ohio over the next 10 years, according to KFF estimates).

The Health Policy Institute of Ohio has released a new brief titled “Access to Mental Health Care for Ohio Children and Youth.”

The brief is the third in HPIO’s Ohio Child Mental Health Project.

Many Ohio children and youth are struggling with mental health conditions. Early identification and treatment can keep them on a path toward well-being and realizing their full potential. However, families around the state are encountering various barriers to getting children the treatment they need, including critical provider shortages (as illustrated above), high costs of care and difficulties navigating the health and insurance systems.

Further, significant gaps in data availability are limiting policymakers’ ability to make data-driven decisions regarding how to improve access to mental health care, which could improve the well-being of young Ohioans and decrease costs for years to come.

This brief focuses on access to mental healthcare services across levels of care. As part of the release, HPIO is also releasing a community voice spotlight on parent and caregiver experiences with barriers to child and youth mental health care.

Data on Ohio children shows that those who experience adverse childhood experiences (ACEs) are more likely to have at least one mental, emotional, developmental or beahavioral condition, as illustrated above.

ACEs are potentially traumatic events that occur during childhood. These can include abuse, neglect or other household challenges, such as living with someone with a mental health condition or substance use disorder or who experienced incarceration. There is clear evidence that ACEs negatively affect brain development and increase the likelihood of numerous physical and mental health conditions through adulthood.

The data was included in HPIO’s policy brief “Factors Contributing to Child and Youth Mental Health Struggles.” The brief, which was released in July, is the second in a series of four planned HPIO publications on child and youth mental health.

The brief describes how each factor influences child and youth mental health, the extent to which it exists in Ohio and what the state is doing to address it. Finally, it presents a variety of policy options that could be implemented to address each topic.

Next Month HPIO is planning to release the third brief in the Child Mental Health series. The new publication will focus on access to mental healthcare services for Ohio children across levels for care.

The Health Policy Institute of Ohio has released a new policy explainer on changes to the federal health insurance marketplace.

The Affordable Care Act health insurance marketplaces are at the center of the federal government shutdown, particularly the upcoming expiration of enhanced premium tax credits that reduce the cost of these insurance plans for consumers. The debate over extending the enhanced credits comes at the same time as broader conversations on the difficulties that Ohio families are facing with the cost of living and increased cost of health insurance.

Nearly 600,000 Ohioans got health insurance through the marketplace in 2025. With enhanced tax credits expiring next year and large increases in the cost of premiums, more than 100,000 Ohioans are expected to no longer purchase insurance coverage in 2026.

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

Two federal judges ruled today (Oct. 31) that the Trump administration is required to use emergency funds to continue paying for Supplemental Nutrition Assistance Program (SNAP) benefits (source: “Judges order the Trump administration to use contingency funds for SNAP payments during the shutdown,” Associated Press, Oct. 31).

The rulings — one in a case brought in Massachusetts by 25 states and D.C., the other in a case brought in Rhode Island by a national coalition of municipalities (including Columbus) and non-profits — came after weeks of uncertainty about the future of SNAP payments amid the federal government shutdown.

The Trump administration had previously announced that those enrolled in SNAP would not receive payments starting tomorrow (Nov. 1) because of the ongoing federal government shutdown. The program has never been disrupted during any previous government shutdowns.

Because of the timing of the rulings, just hours before benefits were set to be halted for some enrollees, it is not immediately clear how quickly the electronic benefits transfer cards that beneficiaries use to buy groceries can be reloaded. That process often takes one to two weeks.

More than 1.4 million Ohioans, or 12% of the population, are enrolled in SNAP, including 723,870 households, as illustrated above. According to a recent fact sheet from the Ohio Association of Foodbanks, the average Ohio SNAP participant receives $5.64 a day. That is substantially less than the average cost of groceries calculated by the United States Department of Agriculture. To qualify for SNAP, Ohioans must have a net income at or below federal poverty guidelines — $32,150 a year for a family of four.

Ohio’s monthly allotment of federal SNAP funding for September 2025 was more than $252 million.

On Thursday (Oct. 30), Gov. Mike DeWine announced that he, Ohio Senate President Rob McColley and Ohio House Speaker Matt Huffman agreed to a plan to provide $25 million for emergency food assistance. According to a news release from the Governor’s office, $7 million will be given to Ohio food banks and up to $18 million will be given as emergency benefits to Ohioans who earn below 50% of the federal poverty level ($16,075 for a family of four). It is uncertain whether this aid will be distributed now that the federal government is required to continue benefits.

The current uncertainty of SNAP benefits comes as states are preparing for significant federal cuts to the program as part of HR 1, the federal reconciliation bill sometimes called the One Big Beautiful Bill Act. That legislation includes $186 billion in cuts to SNAP over the next decade, with significant changes to eligibility and increased costs to states. The Ohio Association of Foodbanks fact sheet includes a timeline of scheduled changes to the program.

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.