Data Graphics

Data included in HPIO’s recently released policy explainer SNAP at a Glance: Key Changes from HR 1 shows that nearly 1 in 8 Ohioans are currently enrolled in the Supplemental Nutrition Assistance Program (SNAP), as illustrated above.

SNAP enables about 1.4 million Ohioans to meet their basic food needs and supports local economies by generating up to $1.50 in economic activity for every $1 in benefits spent.

HR 1, the July 2025 federal reconciliation bill, also known as the “One Big Beautiful Bill Act,” made substantial changes to SNAP that will affect eligibility for the program, as well as how the program is administered by Ohio and other states. Ohio’s share of SNAP costs is projected to rise 268%, from $146 million to nearly $540 million, due

The policy explainer describes how HR 1’s SNAP eligibility restrictions and expanded work requirements are expected to negatively impact the ability of Ohioans to access healthy food.

To learn more about the issue, see this HPIO explainer video featuring co-author Robin Blair-Ackison: https://www.youtube.com/watch?v=_ajDAAsDS-E&t=2s

HPIO has released a new policy explainer titled “SNAP at a Glance: Key Changes from HR 1.”

The Supplemental Nutrition Assistance Program (SNAP) enables more than 1.4 million Ohioans to meet their basic food needs and supports local economies by generating up to $1.50 in economic activity for every $1 in benefits spent.

HR 1, the federal reconciliation bill also known as the “One Big Beautiful Bill Act,” which was enacted in July 2025, made substantial changes to SNAP that will affect eligibility for the program, as well as how the program is administered by Ohio and other states. Ohio’s share of SNAP costs is projected to rise 268%, from $146 million to nearly $540 million, due to provisions in HR 1 that shift more administrative and benefit costs onto states.

Enrollment in SNAP varies greatly in Ohio, from a high of 26% in Pike County to a low of 3.8% in Holmes county, as illustrated above.

The explainer describes how HR 1’s SNAP eligibility restrictions and expanded  work requirements are expected to negatively impact the ability of Ohioans to access healthy food.

Recent data from RecoveryOhio shows that while less than 1% of all accidental drug overdose deaths in Ohio from 2019 to 2024 involved kratom, the number has increased by 180%, as illustrated above.

Kratom is a stimulant that has opioid-like effects and, until recently, was sold in natural and synthetic forms over the counter as a supplement at retail stores in Ohio.

The Ohio Board of Pharmacy recommended last month that all forms of kratom be reclassified as Schedule 1 controlled substances. That decision came shortly after Gov. Mike DeWine issued an executive order banning synthetic kratom.

The Pharmacy Board rules banning mitragynine, the primary psychoactive chemical found in kratom, will not be finalized for at least a few months. The rules still need to be reviewed by the Common Sense Initiative in the governor’s office and the Ohio General Assembly’s Joint Committee on Agency Rule Review.

Data included in HPIO’s recently released policy brief on the Connections between Youth Mental Health and the Juvenile Justice System shows that Ohio youth who are Black or Hispanic, from rural counties and from families earning less than 250% of the federal poverty level (FPL) are more likely to have had a parent or guardian serve time in jail.

The brief found that there are several factors that contribute to poor mental health among children and teens, but some are more common among youth who become involved in the juvenile justice system, including adverse childhood experiences (ACEs).

Certain ACEs are more common among youth who become justice-involved, specifically sexual abuse, neglect and living in a household with someone who was incarcerated. According to HPIO’s Health Impacts of ACEs in Ohio brief, sexual abuse and incarceration of a household member are also two of the ACEs that have the most significant impact on the health of Ohioans.

The brief includes nine policy options that state policymakers can implement, and for which juvenile justice and child mental health partners can advocate, to improve mental health outcomes for at-risk youth and prevent justice involvement. The policy options, which were identified through a review of the U.S. Department of Justice Crime Solutions inventory, and through the expertise of the HPIO Child Mental Health advisory group, aim to prevent delinquent behavior, promote accountability, cultivate community safety and support the mental health of youth in detention or commitment.

The federal government has begun releasing guidance on the implementation of new restrictions to provider taxes that many states, including Ohio, use to generate revenue to pay for their Medicaid programs (Sources: “CMS finalizes rule cracking down on Medicaid provider taxes,” Healthcare Dive, Jan. 30 and “CMS Issues New Guidance on H.R. 1’s Restrictions on State Use of Provider Taxes to Finance Medicaid,” Georgetown University Center for Children and Families blog, Nov. 18).

Medicaid is funded jointly by states and the federal government. Provider taxes comprise approximately 17% of state Medicaid funds nationally. Ohio’s three largest provider taxes accounted for $3.2 billion in state revenue in SFY2025, as illustrated above. Provider taxes draw down federal matching dollars, enabling states to increase and improve healthcare access for residents.

Changes to provider tax rules included in HR 1, sometimes referred to as the One Big Beautiful Bill Act, will reduce federal Medicaid spending by $226 billion over the next decade, according to the Congressional Budget Office. For example, unless Ohio leaders change pieces of the state’s existing Health Insuring Corporation (HIC) franchise fee to comply with the new federal rules, Ohio could lose approximately $3 billion a year in decreased taxes collected and federal draw-down amounts starting in SFY 2028. Other provisions in HR 1 will affect Ohio’s hospital franchise fee in the coming years as well.

HPIO plans to release a policy explainer on Medicaid financing in the coming weeks that will provide additional details on how Ohio pays for its Medicaid program and highlight upcoming decisions state policymakers will face in response to federal policy changes.

Data released this week by the Centers for Medicare and Medicaid Services shows that 469,616 Ohioans enrolled in Affordable Care Act (ACA) marketplace coverage in the open enrollment period that ended Jan. 15, a decrease of nearly 114,000 from last year (20%), as illustrated above.

Ohio saw the second-largest percentage drop in enrollment of any state in the country following the expiration of enhanced premium tax credits.

The national drop in enrollment was 5%, with states running their own exchanges retaining more enrollment than those, like Ohio, that use the federally operated exchange. According to KFF analysis, the drop in enrollment is likely to be even steeper in coming months because “people who have selected a plan or been automatically renewed may not ultimately choose to pay for their plan, thus ‘effectuating’ their coverage.”

Marketplace enrollment in Ohio had more than doubled between 2021 and 2025, when COVID-era enhanced subsidies decreased monthly premiums by 41%. The tax credits were at the center of the federal government shutdown last year, with Congress ultimately failing to reach an agreement on extending them.

While data on average premium payments in 2026 have not been released, the expiration of the tax credits was expected to increase premiums, on average, by 114% in 2026.

In November, HPIO released a policy explainer that provides background about the ACA marketplaces and details how recent changes to the marketplace could impact Ohioans in 2026.