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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 60th anniversary 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.

The Health Policy Institute of Ohio has released a new brief titled “Factors Contributing to Child and Youth Mental Health Struggles.” The brief is the second in a series of four planned HPIO publications on child and youth mental health.

“Ohio children and youth are experiencing significant mental health challenges, with increases in overall rates of mental health conditions and higher rates compared to the U.S. overall in recent years,” according to the brief.

There are a variety of factors that influence a child's mental health. The brief focuses on three important contributing factors:

• Smart phones and social media
• Housing instability and homelessness
• Child protective services and foster care system involvement

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.

From 1 p.m. to 2 p.m. on Thursday, July 31, 2025, HPIO will be hosting a webinar to explore key findings from the brief. Speakers will include lead author, Becky Carroll, Director of Policy Research and Analysis at HPIO and Linsday Green, Behavioral Health and Wellness Coordinator at Miamisburg City Schools. More speakers are expected to be announced soon.

The federal spending package that was signed into law last week will lead to a $37 billion reduction in federal Medicaid funds in Ohio over the next decade, KFF analysis projects.

Using estimates from the Congressional Budget Office, which showed that the bill would cut Medicaid by $1 trillion between 2025 and 2034, KFF projects that Ohio could receive 14% less in federal dollars for Medicaid. Every state is expected to lose funding, as illustrated above, but Ohio will lose more than all but six states, according to the analysis.

An analysis of the health impacts of the federal legislation by the National Academy for State Health Policy found that "The impact on state budgets will be felt most significantly by the 40 states and Washington, D.C., that have expanded Medicaid, with between 10 and 21 percent reductions in federal spending … State leaders will need to make decisions on how to account for federal funding reductions, with limited options for new dollars to make up any gaps."

As celebrations for Pride Month conclude, national data shows that living in accepting communities can prevent harm for LGBTQ+ young people.

In Ohio, gay, lesbian and bisexual youth are nearly 3 times more likely to report a suicide attempt in the past 12 months, with one in five (20%) gay, lesbian and bisexual high school students reporting that they attempted suicide in 2023, according to data from the CDC’s Youth Risk Behavior Survey. However, national data from the Trevor Project shows that LGBTQ+ young people who reported living in very accepting communities attempted suicide at less than half the rate of those who live in very unaccepting communities, as illustrated above.

HPIO’s 2024 Health Value Dashboard includes an equity profile for LGBTQ+ Ohioans. The Dashboard details how homophobia and transphobia are primary drivers of poor outcomes experienced by LGBTQ+ Ohioans of all ages. Experiencing discrimination can cause toxic stress, leading to poor health outcomes over time. Thus, LGBTQ+ Ohioans often experience worse outcomes than heterosexual and/or cisgender Ohioans across measures of health and social well-being. Policies and practices that limit access to necessary health care and a lack of protections for Ohioans based on sexual orientation and gender identity contribute to worse health outcomes for LGBTQ+ people compared to their heterosexual and/or cisgender peers.

The U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) released a statement last week announcing that specialized services for LGBTQ+ youth who call the 988 national suicide prevention hotline will no longer be in operation starting July 17.

There are evidence-informed strategies that Ohio leaders can adopt to improve health disparities for LGBTQ+ Ohioans. By collecting data about the experiences of the LGBTQ+ community, ensuring access to developmentally appropriate care, improving provider education and including sexual orientation and gender identity in anti-discrimination laws, Ohio can create more accepting communities and close gaps in health outcomes for LGBTQ+ Ohioans.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org 24/7 for free and confidential support. The Trevor Project operates a 24/7 suicide prevention hotline for the LGBTQ+ community at 1-866-488-7386 (or text START to 678-678) and the Trans Lifeline suicide hotline operates Monday through Friday from 1 p.m. to 9 p.m. at 1-877-565-8860.

As the Ohio General Assembly continues negotiations in conference committee, a provision remains in the state’s biennial budget plan that would eliminate Medicaid expansion if the federal government reduces the Federal Medical Assistance Percentage (FMAP) (i.e., federal match) for those enrolled in this group.

A conference committee vote on the budget is expected next week and Gov. DeWine will then have the opportunity to line-item veto provisions in the budget. The Governor is required to sign the bill into law by June 30.

Data and projects included in HPIO’s recently completed 2025 Ohio Medicaid Expansion Study show that eliminating Medicaid expansion would lead to a projected 80% increase in the number of Ohioans who are uninsured. Ending expansion would also mean that Ohio would lose more than $1 billion a year in federal funds that are used to pay for mental health and substance use treatment, among other negative economic outcomes for the state.

Even if the complete elimination of Medicaid expansion does not occur, other changes under consideration at the state and federal levels could impact coverage and funding for services.

HPIO’s 2025 Ohio Medicaid Expansion Study includes a series of five reports looking at various facets of the issue, including Access to mental health and substance use disorder treatment, parents, caregivers and their children, the state budget, health insurance coverage and cost and jobs and the economy.

HPIO’s 2025 Ohio Medicaid Basics and Policy Considerations: The Future of Group VIII (expansion) Medicaid Coverage in Ohio brief contain more general information on the Medicaid program overall and considerations about Medicaid expansion coverage as policymakers consider the program's future.