Medicaid is a critical form of health coverage across the state, particularly in rural and Appalachian counties, as illustrated above.

As of September 2026, there were more than 2.9 million Ohioans — about 1 in 4 people in the state — enrolled in Medicaid. This includes 1.1 million children, about 39% of all Ohio children, according to data from the Ohio Department of Medicaid.

Medicaid coverage has been shown to improve access to care, health outcomes and financial security. For example, Medicaid expansion is associated with improvements in cancer survival rates.

As Governor-elect Amy Acton and members of the upcoming 137thGeneral Assembly take office in January, they will have to make a number of policy decisions related to the financing and operation of the state’s Medicaid program.

Medicaid policy changes can have major impacts on program enrollees and the state more broadly and typically require policymakers to consider important trade-offs. For example, increasing provider reimbursement rates can improve care access and health outcomes, while at the same time increasing the cost of services. Conversely, narrowing program eligibility may reduce costs for Ohio, but simultaneously lead to worsened health outcomes in the state and financial strain on providers as the uninsured population grows. State policymakers are tasked with balancing the benefits of providing healthcare coverage with the cost of paying for services.