Data Graphics

As Ohio and federal policymakers consider the future of expanded Medicaid eligibility, a new illustration from HPIO shows examples of the types of jobs with average pay that would currently make Ohioans eligible for Medicaid under expansion.

The graphic is included in HPIO’s recently released brief “Policy Considerations: The Future of Group VIII (expansion) Medicaid Coverage in Ohio.”

As the U.S. Congress deliberates plans to reduce federal spending, including proposals to drastically cut funding for Medicaid, Gov. Mike DeWine included in his state budget proposal a provision that if the federal share of Medicaid funding is reduced, the Ohio Department of Medicaid “shall immediately discontinue all medical assistance for members of the [Medicaid expansion] group.”

This would drastically reduce access to health care for hundreds of thousands of Ohioans, most of whom are employed. In 2018, Medicaid reported that 94% of Group VIII enrollees were either employed, in school, taking care of family members (such as children or grandchildren), participating in an alcohol and drug treatment program or dealing with intensive physical health and/or a mental health illness.

The income eligibility limit for Medicaid enrollees is set as a percentage of FPL, as displayed to the right. FPL thresholds are based on household Modified Adjusted Gross Income, and are determined monthly. The illustration above shows examples

Learn more about Medicaid in Ohio by viewing HPIO’s recently released Ohio Medicaid Basics 2025.

Data included in a recent HPIO data snapshot shows that a federal expansion of the child tax credit (CTC) led to a sharp drop in child poverty, as illustrated above.

HPIO released last week a new data snapshot highlighting Effects of the Child Tax Credit on poverty, health and well-being. This data snapshot highlights the potential impact of increased, refundable child tax credits.

Tax policies are powerful tools for reducing poverty, promoting financial security and improving population health. The 2021 American Rescue Plan Act both increased the amount of the federal Child Tax Credit (CTC) and made it fully refundable. The expansion expired at the end of 2021, returning the credit amount to pre-pandemic levels.

Gov. Mike DeWine’s biennial budget proposal calls for a refundable $1,000 CTC for eligible families with children 6 years old and under, funded by an increase in cigarette tax revenue.

The federal CTC expansion led to a drop in national child poverty by 55% in 2021, with deep poverty (income less than half of the federal poverty level) and extreme poverty (living on $2 or less a day per person) effectively eliminated. After the expansion expired in January 2022, child poverty spiked by 41% nationally. Census data also shows a drop in child poverty rates in Ohio during 2021.

The publication page also includes a link to download the graphics from the snapshot to use in your work or to share on social media.

HPIO has released a new brief titled “Policy Considerations: The Future of Group VIII (expansion) Medicaid Coverage in Ohio.”

In 2014, when Ohio expanded Medicaid eligibility under the federal Affordable Care Act (ACA) to adults earning less than 138% of the federal poverty level (FPL), the federal government funded 100% of the expansion population (also known as Group VIII). The ACA laid out a schedule for reducing the federal match rate (FMAP) from 2016 to 2020 to its current 90%-10% split between federal and state government.

As displayed above, the percentage of working-age Ohio adults (ages 19-64) with lower incomes who are uninsured dropped by 62% from 2012 to 2023 and the percentage who are enrolled in Medicaid increased by 61%.

As the U.S. Congress deliberates plans to reduce federal spending, including proposals to drastically cut funding for Medicaid, Gov. Mike DeWine included a provision in his state budget proposal that if the federal share of Medicaid funding is reduced, the Ohio Department of Medicaid “shall immediately discontinue all medical assistance for members of the [Medicaid expansion] group.”

This publication provides data and information on the status of Medicaid expansion in Ohio and includes a series of policy considerations for state and federal leaders. The publication page also includes a link to download the graphics from the snapshot for use in your work or to share on social media.

In the coming weeks, HPIO plans to release additional resources to assist policymakers who are evaluating options related to Medicaid coverage in Ohio. The Institute also recently released the latest edition of its biennial Ohio Medicaid Basics publication, which provides an overview of the Ohio Medicaid program, including eligibility, covered services, spending and recent policy changes.

On Thursday, HPIO President Amy Rohling McGee testified before the House Finance Committee to share the information in this policy considerations document.

The Health Policy Institute of Ohio has released a new publication titled Public Health Basics, which offers detailed insights into the state's public health services, workforce and the challenges they encounter.

“We often think about the decisions we make, like whether we go for our annual medical checkups, brush our teeth or exercise, as being the main contributors to our health,” according to the brief. “We forget or take for granted everything that makes it possible for us to be healthy and avoid illness, such as whether our food and water are safe, we have access to vaccines and know how to avoid health risks. Clinical care influences just 20% of our health outcomes, while the remaining is shaped by health behaviors (30%) and the social, economic and physical environment (50%). This is where public health plays a vital role.”

In 2021, Ohio Department of Health (ODH) spent $24 per capita on public health, far less than most other states (as illustrated above). Overall, Ohio’s investment in public health is lower than many other states at both the state and local levels.

HPIO has also released a companion Public Health Workforce fact sheet  and a one-page "quick facts" document that provides a brief overview of public health in Ohio.

Data compiled by HPIO shows that more than 770,000 Ohioans (over 6% of the total population) are enrolled in Medicaid through Group VIII (also known as the expansion group). The highest rates of enrollment in this group are found in metropolitan and Appalachian counties, as displayed above.

Group VIII coverage includes adults ages 19 to 64 who have incomes less than 138% of the federal poverty level and are not eligible for other categories of Medicaid (click here to see a table of Medicaid enrollment for all 88 Ohio counties).

The expansion of Medicaid eligibility has been a major contributor to Ohio’s uninsured rate dropping by half, from 14% in 2010 to 7% in 2022. The state is ranked 16thbest in the nation for uninsured rate, according to HPIO’s 2024 Health Value Dashboard.

In 2013, when Ohio expanded Medicaid eligibility under the federal Affordable Care Act, the federal government funded 100% of the expansion population. That was reduced gradually from 2016 to 2020 to its current 90%-10% split between the federal and state government.

As the U.S. Congress deliberates plans to reduce federal spending, including proposals to drastically cut funding for Medicaid, Gov. Mike DeWine included in his state budget proposal a provision that if the federal share of Medicaid funding is reduced, the Ohio Department of Medicaid “shall immediately discontinue all medical assistance for members of the [Medicaid expansion] group.”

This would drastically reduce access to health care for hundreds of thousands of Ohioans, most of whom are employed. In 2018, Medicaid reported that 94% of Group VIII enrollees were either employed, in school, taking care of family members (such as children or grandchildren), participating in an alcohol and drug treatment program or dealing with intensive physical health and/or a mental health illness.

Learn more about Medicaid in Ohio by viewing HPIO’s recently released Ohio Medicaid Basics 2025.

Data shows that there has been a steady increase in educational attainment among Black Ohioans over the course of nearly a century, as illustrated above. During Black History Month and every month, we celebrate the history, culture and contributions of Black communities that strengthen our country and the state of Ohio. While Black communities have faced barriers to justice, including access to quality education, they remain resilient.

Education is a longstanding value of Black communities as demonstrated by the United Negro College Fund’s well-known slogan: “The mind is a terrible thing to waste, but a wonderful thing to invest in.”

Previous HPIO work has found that education is an important social driver of health and is associated with better health and a longer life. While educational attainment alone does not guarantee improved outcomes without addressing other barriers, a gap in education attainment still exists. It is important for Ohio to support polices that provide and protect equitable access to quality education.