Data from the U.S. Census Bureau shows that Ohio’s uninsured rate for children climbed to 5.2% in 2024, its highest level in a decade, as illustrated above.

According to the federal data, 136,900 Ohio children did not have health insurance in 2024. That is the highest number since 2014, when 137,200 children in the state were uninsured.

2014 was the year Ohio began Medicaid expansion. Although children in lower-income families were eligible for Medicaid prior to Ohio’s decision to implement the Affordable Care Act’s Medicaid expansion provision, their parents and other family members may have gained coverage because of the policy change. Research has found that as more adults gain access to insurance coverage, more children also tend to become insured[BO1] (sometimes called the “welcome mat” effect).

The increase in the child uninsured rate comes as states prepare for HR1 provisions such as Medicaid work requirements, restrictions to Medicaid funding and more frequent eligibility verifications. These changes, which will take effect in the coming months, are projected to increase the number of Americans without insurance by 7.6 million over the next decade, according to national projections from the RAND Corporation.

While these provisions do not specifically impact child enrollment, the loss of Medicaid coverage for adults will likely impact coverage for children. And higher premiums for families covered through the ACA marketplace following the expiration of enhanced subsidies in 2025 are also likely contributing to additional coverage loss in Ohio.[BO2]