Ohio Medicaid Basics 2025

Published every other year since 2005, to coincide with the biennial budget process, the 11th edition of HPIO's Ohio Medicaid Basics provides an overview of the Ohio Medicaid program, including eligibility, covered services, spending and recent policy changes. 

Medicaid is a public program that offers health insurance and other services to groups experiencing economic disadvantage, including children and families with low incomes, older adults and people with disabilities. These groups face unique challenges, including costly and complex health needs, challenging community conditions and socioeconomic barriers to health and well-being. The Medicaid program fortifies individuals and families against the financial strain of receiving needed health care.

Established by the Social Security Act of 1965, the federal and state governments partner to cover healthcare services for about 80 million people nationwide through the Medicaid program. There are more than 3 million Ohioans — more than 1 in 4 people in the state — enrolled in Medicaid. This includes more than 1.2 million children. In State Fiscal Year (SFY) 2024, federal and state expenditures on Medicaid accounted for about 39% of Ohio’s state operating budget.

HPIO will analyze the impact of future state and federal Medicaid policy changes, such as Ohio’s proposed Medicaid work requirements, in future publications.

HPIO has also created a two-page "quick facts" overview of Medicaid in Ohio.

See Appendix for more details on Medicaid eligibility categories.

3 Key findings for policymakers

• Medicaid provides healthcare coverage for about 26% (3 million) of Ohioans, including children, pregnant women, older adults, people with disabilities and adults with low incomes.
• Enrollment in Ohio Medicaid peaked in March 2023 but has steadily declined since the resumption of regular eligibility redetermination process, which was paused during COVID-19. However, Medicaid enrollment is still 9% higher than it was before the pandemic (as of December 2024).
• Medicaid represents a significant share of government spending in Ohio and most of the cost is born by the federal government. In state fiscal year 2024, federal and state expenditures on Medicaid were nearly $39 billion, with 69% coming from the federal government.

Facts and Figures

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