Data Graphics

As children in Ohio and across the country begin a new school year, data shows that while Ohio ranks 10thin the nation for fourth grade reading, just 35% of the state’s public-school students scored proficient or above in reading comprehension in 2022, as illustrated above. That was a slight decline from 2019, when 36% of students scored proficient or above.

There was also a racial disparity in fourth grade reading proficiency, with Black and Hispanic students more than half as likely to be proficient by fourth grade as their white peers. The percentage of students of all races demonstrating reading proficiency dropped during the COVID pandemic.

Last school year was the first in which a new state requirement went into effect mandating that all Ohio school districts adopt curriculum that aligns with the science of reading, which is based on decades of research that shows how the human brain learns to read and incorporates phonemic awareness, phonics, fluency, vocabulary and comprehension.

That requirement was championed by Gov. Mike DeWine and was approved as part of the 2023-2024 state budget.

Ohio is one of 40 states and the District of Columbia that has passed laws or implemented new policies related to evidence-based reading instruction since 2013, according to an Education Week analysis.

For many years, HPIO has produced publications that explore the evidence demonstrating the strong connection between education and health.

Both children and adults in Ohio turn to emergency departments for preventable dental issues at far higher rates than the national average.

In 2022, Ohio children on Medicaid were nearly twice as likely as children nationwide to visit the ED for dental caries. And Ohio adults experienced higher rates of ED visits for non-traumatic dental conditions than the rest of the country, as illustrated above.

These patterns highlight gaps in access to preventive oral health services and underscore the need for new approaches to address the issue. One of those approaches is the MORE Care® Ohio pilot, which brings medical and dental providers together to integrate oral health into pediatric primary care, expanding access and prevention for children across the state.

The pilot, which is highlighted in CareQuest Institute for Oral Health’s Partners in Progress report, demonstrates how collaboration, training and data-driven approaches can bridge gaps in care and reduce disparities, especially in rural areas. To advance this work, HPIO and Oral Health Ohio recently convened stakeholders from across Ohio to discuss findings, share perspectives and explore strategies for scaling integrated care models statewide.

For more evidence-informed strategies to improve oral health in Ohio, see the State Oral Health Plan 2023-2027.

The Health Policy Institute of Ohio has released a new fact sheet that outlines major federal and Ohio healthcare access and affordability policy changes.

The document provides a high-level summary of several provisions of HR 1, the federal reconciliation bill sometimes referred to as the “Big Beautiful Bill,” along with information about related changes contained in HB 96, the state biennial budget bill.

Among many other provisions, these pieces of legislation contain Medicaid and health insurance policy changes. For example, according to estimates from KFF, Ohio is expected to lose more than $33 billion dollars in federal Medicaid funding compared to baseline over the next decade as a result of HR 1, as illustrated above.

In the coming months, HPIO plans to release several briefs that will explore how these changes are likely to impact healthcare affordability in Ohio. Many of the one in four Ohioans (about 3 million people) who have health coverage through Ohio’s Medicaid program and the more than 580,000 Ohioans who have health insurance obtained through the federal marketplace are expected to experience the most significant impacts of these changes.

For many working Ohioans, the cost of basic necessities — such as housing, childcare, food, transportation and health care — is outpacing their income. A tool developed by United Way shows that a family of four with an infant and a preschool child in Ohio needs to earn $79,224 to afford living expenses. And in some parts of the state, the income needed is more than $90,000, as illustrated above.

More than a century of research has found strong connections between income and health. Many factors, including social, economic and physical environments, impact the likelihood that an individual will attain higher quality employment. In turn, workers who attain higher quality employment are more likely to have access to employment-related supports that can improve health, such as higher wages, health insurance coverage and paid time off.

In the coming weeks, HPIO plans to release a series of publications exploring health care affordability challenges in Ohio, and the potential impact of recent federal policy changes, such as Medicaid work requirements and cost-sharing, following the passage of the HR1 spending bill.

Over the past decade, there have been major policy changes to improve access to care, including Ohio’s expansion of Medicaid eligibility in 2014, which contributed to Ohio’s uninsured rate dropping by half from 2010 to 2022, as illustrated below.

In HPIO’s 2024 Health Value Dashboard, Ohio ranked 16th lowest uninsured rate compared to other states and D.C.

As part of HPIO’s recently completed 2025 Ohio Medicaid Expansion Study, the Institute examined the expansion’s impact on health insurance coverage and cost. Data included in the brief shows that if expansion was eliminated, the uninsured rate could increase by 80% in 2026. Certain groups of Ohioans, including Ohioans with a high school education or less, would be more likely to become uninsured.

Next Wednesday, July 30, is the 60thanniversary of the Social Security Act of 1965, legislation signed by President Lyndon B. Johnson that created Medicare and Medicaid.

Data included in HPIO’s “Ohio Medicaid Basics 2025” shows that more than 1 in 3 Ohioans have health coverage through either Medicare or Medicaid, as illustrated above.

Medicaid is a federal-state partnership in which the federal government sets guidelines and provides partial funding, with each state designing and administering its own program. Meanwhile, Medicare is fully administered and financed by the federal government. Medicare primarily serves Americans ages 65 and older, while Medicaid serves low-income individuals of all ages and other groups determined to be eligible.

Many Ohioans who have low incomes enroll in Medicaid, the second-most common source for coverage in Ohio, in part because other health insurance coverage is unavailable, too expensive or does not provide coverage for needed services, such as long-term services and supports.

Medicaid requires state policy decisions, plays a significant role in coverage for Ohioans and accounts for a substantial portion of the state budget (in state fiscal year 2024, federal and state expenditures on Medicaid accounted for about 39% of Ohio’s state operating budget). Because of this, analyzing and explaining the program has been central to HPIO’s mission since its founding. Since 2005, HPIO has produced Ohio Medicaid Basics every two years so that state policymakers and those who influence them have a better understanding of the program.

You can access HPIO’s work related to Medicaid, healthcare access and coverage by clicking here.