2025 OHIO MEDICAID EXPANSION STUDY
Background
Since Ohio expanded Medicaid eligibility in 2014, hundreds of thousands of residents with lower incomes – including people who are working, parents, grandparents, veterans and caregivers – have gained access to medically necessary health care. As of March 2025, nearly 770,000 Ohioans are covered through Medicaid expansion.
The federal Affordable Care Act (ACA) and a subsequent U.S. Supreme Court decision permitted states to expand Medicaid eligibility to adults earning less than 138% of the federal poverty level (FPL). The federal government pays 90% of the cost of the Medicaid expansion group and the state government pays 10%.
Ohio policymakers are considering discontinuing Medicaid expansion coverage under the proposed 2026–2027 biennial state budget (House Bill 96), which includes a provision to end the program if the enhanced Federal Medical Assistance Percentage (FMAP) drops below 90%. The change would have a significant impact on the economy, state finances and the health of Ohioans.
To inform this proposed policy change, HPIO is releasing a series of briefs that summarize data and research on the potential impact of the change. The 2025 Ohio Medicaid Expansion Study is a comprehensive, data-driven study to describe how the expansion of Medicaid in 2014 impacted coverage, access and affordability and it estimates the future impacts of discontinuing coverage for the expansion population.
Click here for a 4-page summary of all five briefs in this series
Briefs in this series
HPIO is partnering with subject matter experts and two national research organizations, Urban Institute to conduct state budget impact modeling and Regional Economic Partners to undertake economic modeling. The findings from the study will be included in a series of reports that look at:
► Access to mental health and substance use disorder treatment
► Parents, caregivers and their children
Additional Resources
- Eliminating Medicaid Expansion in Ohio in Response to Reduced Federal Funding, prepared for HPIO by the Urban Institute
- Policy Considerations: The Future of Group VIII (expansion) Medicaid Coverage in Ohio, contains more general information and considerations about Medicaid expansion coverage as policymakers consider the future of the program
- Ohio Medicaid Basics 2025, provides an overview of the Ohio Medicaid program, including eligibility, covered services, spending and recent policy changes
- 4-page summary of all five briefs in this series
Facts and Figures
Use HPIO graphics and data in your work. To use the data graphics in your presentations, click here to access the slides on Google Drive, click “File” and then “Download.” This will allow the option to download individual slides or the full deck into PowerPoint slides, a jpg, pdf or other available media files.
Funders
Generous contributions from the following organizations have made the study possible:
