Ohio Medicaid Basics 2021
This publication provides an overview of the Medicaid program in Ohio, including information on Medicaid eligibility, covered services, delivery systems, financing, spending and recent policy and programmatic changes. This brief also examines how the COVID-19 pandemic impacted Ohio Medicaid and discusses significant changes to Ohio Medicaid in the past year.
The Medicaid program is a partnership between the federal and state governments that pays for healthcare services for approximately 3.18 million Ohioans with low incomes, including more than 1.28 million children. In state fiscal year (SFY) 2020, federal and state expenditures on Medicaid accounted for about 38% of Ohio’s budget. And $1 out of every $6 spent on health care in the U.S. is spent on Medicaid.
The federal government finances a significant portion of state Medicaid programs. States are required to provide coverage for certain federally-defined eligibility groups and services. States can also receive federal funding for optional groups and services. The specific parameters around who is covered and what services are covered are defined through a combination of federal and state statutes, rules and regulations and administrative decisions.
As the payor of healthcare services for more than a quarter of all Ohioans, Medicaid can be leveraged to make large-scale policy changes that impact the health of residents. For example, the federal government can grant flexibility to states and even waive certain requirements as long as the statutory goals of the program are met. However, even with substantial federal financial participation, the high cost of the program is a challenge for state finances. Policymakers must balance the benefits of providing healthcare coverage with the cost of paying for services.