Initial reflection on the 2024-2025 budget

The 2024-2025 state budget is wrapped. While we’ll spend a lot more time and blog-space on how this state budget will impact health and human services, this initial reflection on the budget provides a quick look at where The Center for Community Solutions’ budget priorities landed.

Improving the health of Ohio’s kids and moms

Community Solutions’ budget priorities included several goals where Medicaid and women’s and children’s health were intertwined, as is often the case, since Medicaid covers about half of all births in the state and about 1.4 million Ohio children. We aimed to improve women’s and children’s health in Ohio through:

  • expanded Medicaid coverage for children and pregnant women
  • continuous Medicaid coverage for children
  • expanded access to doula services

✅ Included in the final budget, Ohio Medicaid will provide continuous health coverage for children from birth to their 4th birthday. Continuous coverage means that once a child in this age range is enrolled in Medicaid, they would stay enrolled without an annual redetermination, until the age the continuous coverage ends. Also included in the budget is a certification process for and a plan for Medicaid to cover doula services. Governor DeWine did veto components of the language around doulas, but this was in order to update the language in the budget bill to align with the current goals of the legislature and the administration around expanded access to doula services. The doula certification process and Medicaid’s coverage of the services remains in the final budget.

The doula certification process and Medicaid’s coverage of the services remains in the final budget.

❌What did not make it into the final budget was the Governor’s proposal to expand Medicaid coverage for kids and pregnant women up to 300 percent of the federal poverty level. The House had maintained this provision, but the Senate removed it. The language did not make it back in during the budget conference committee. While the Governor can veto provisions in the language, he cannot add back in anything that was removed or any new policies.

  • ✅ The Governor’s proposed new agency, the Department of Children and Youth, was signed into law with the final budget.
  • The agency will coordinate programming related to kids, of all ages, within one agency.

The Governor shared at a post-budget press conference on July 5, 2023 that the plans for this new agency began before the budget was passed and that we should expect to hear announcements about more specific plans soon.

Protecting and strengthening the health and human services safety net

✅ There were significant threats to the Supplemental Nutrition Assistance Program (SNAP) as the budget made its way through the Senate. Harmful policies like asset tests and SNAP photo IDs that would threaten access to SNAP, were removed either before the Senate passed the budget or in the conference committee process. At the outset, one of our budget priorities was protecting SNAP, and other human services programs, from harmful policy changes that could threaten access. We are grateful that our collective voices were heard when it came to removing these policies from the final budget.

One policy that remains in the budget is a requirement for the Department of Medicaid to develop a work requirement for the Medicaid program and apply to the federal government to operate the waiver by March 2025. We have been down this road before. The Biden Administration has disallowed prior attempts at work requirements. Work requirements are ineffective at connecting people with work and simply serve to force people off the program. Health care is vital to be able to be healthy enough to work, and requiring it to receive coverage is counter to the goals of the Medicaid program. Community Solutions will stay engaged in conversations around the work requirement.

Advancing the wellbeing of older Ohioans

✅ The Governor proposed increased funding for adult protective services, which was maintained by both the House and Senate. While this funding was secure through the budget debates, the Healthy Aging grants and funding for Senior Community Services was a different story.

  • Healthy Aging grants, $40 million in FY2024, will be administered through local partners.
  • Grants can be used to help older Ohioans live safely in homes, which often only need minor modifications as folks age.
  • Supports could include retrofitting the homes of older residents to address challenges with utilizing stairs, installing bathtub rails and providing other supports, like nutrition services and transportation.

With an aging population, supporting these grants will go a long way in helping older Ohioans continue to live safely in their homes. The House supported the Healthy Aging grants, but the Senate removed them entirely from its version of the budget. These grants were added back in during the conference committee.

There were reductions to the Senior Community Services line in both the House and Senate passed versions of the budget, compared to the Governor’s introduced budget. Ultimately, the House’s reduction was maintained, but the further reduction by the Senate was reversed. We will continue to take a close look at the impact that these changes will have.

Enhancing behavioral health access

✅The Governor outlined significant new investments to mental health and addiction services in his introduced budget, which were largely maintained through the budget process. Community Solutions focused on supporting continued implementation of OhioRISE, the state’s Medicaid program to support multi-system youth. The planned investments in children’s behavioral health, focused on building up Ohio’s treatment workforce, will contribute to growing OhioRISE’s impact and reach.

❌The dedicated state funding that supports harm reduction programs, in the Ohio Department of Health’s budget, was eliminated in the House-passed budget and was not added back in through the remainder of the budget process.

There is so much policy change, in addition to dealing with tens of billions of dollars, in the state budget and we look forward to shedding more light on where the budget landed.


As we continue to dig through the policy changes in the budget, Community Solutions will share much more analysis over the next several weeks. There is so much policy change, in addition to dealing with tens of billions of dollars, in the state budget and we look forward to shedding more light on where the budget landed.