Medicaid has received a lot of attention recently in Ohio from advocates, policymakers, and other interested parties. This is the result of two things. The first is the importance of Medicaid as it provides essential health coverage to millions of Ohioans, including low-income families, older adults, and people with disabilities. As a joint federal-state partnership, Medicaid helps ensure that Ohioans can access primary care, prescription medications, and long-term services while stabilizing the state’s health care system by reducing uncompensated care costs.
Two noteworthy threats in the state include the state’s recently submitted Group VIII (expansion group) work requirement and the trigger language in Governor Mike DeWine’s 2026-2027 state budget proposal.
Another reason Medicaid has received so much attention lately is the result of the threats it is facing. Two noteworthy threats in the state include the state’s recently submitted Group VIII (expansion group) work requirement and the trigger language in Governor Mike DeWine’s 2026-2027 state budget proposal. The Governor’s recommended budget includes a provision that would essentially end Medicaid expansion in Ohio if the federal medical assistance percentage for medical assistance provided to members of the expansion eligibility group is set below ninety percent.
The Joint Medicaid Oversight Committee held a hearing on March 20, 2025, where Director Maureen Corcoran from the Ohio Department of Medicaid was invited to provide a review of the Group VIII Work requirement that was submitted to the Centers for Medicare and Medicaid Services. Additionally, Greg Moody, the former Executive Director of Ohio’s Office of Health Transformation, was invited to provide a review of the history and impact of the Group VIII Medicaid expansion in Ohio.
Director Corcoran spoke about Group VIII waiver and budget considerations
Director Corcoran provided a review of Ohio’s Group VIII Section 1115 demonstration waiver to include work requirements as part of the eligibility requirements for the adult Medicaid expansion population (Group VIII). She noted that the impacted population includes nearly 800,000 individuals and that 73% are expected to maintain coverage due to work, exemptions, or other Medicaid eligibility. This leaves approximately 215,000 people who require further evaluation. Overall, Director Corcoran estimated that 62,000 Ohioans would lose eligibility over the next biennium. She urged caution with the Department’s estimates until the definitions are finalized.
Individuals applying for Medicaid after the implementation would be subject to new work requirements.
Director Corcoran closed by sharing that if the waiver is approved, individuals applying for Medicaid after the implementation would be subject to new work requirements, and those already enrolled would be assessed during their next eligibility renewal. She noted that Ohio anticipates spending $630,535 on new requirements in FY 2026 but expects savings of $7.2 million by FY 2027.
Greg Moody offered history and highlighted the importance of Medicaid
Greg Moody began his testimony by discussing the history of Medicaid expansion in Ohio and the state of Ohio’s health care system leading up to expansion. Moody highlighted the challenges that were pervasive across the state at the time, including the increasing problem of opioid addiction, private insurance shouldering the cost of unpaid care by hospitals, and rural hospitals closing.
Prior to Medicaid expansion, Ohio Medicaid covered children, some parents, pregnant women, seniors, and people with disabilities based on certain criteria. After Medicaid expansion, individuals and families with incomes between 0-138% of the federal poverty level (FPL). Individuals who did not have any other access to coverage between 139-400% of the FPL are eligible for marketplace subsidies.
Moody moved to then articulate the impact of expansion and its benefits. Medicaid expansion assisted 700,000 Ohioans to receive health care coverage, provided more access to primary care while reducing emergency room visits, and cutting medical debt. Greg Moody moves finally to the last portion of the testimony, where he highlights the threats Ohio’s budget poses to Medicaid expansion within HB 96. Greg Moody closes out his testimony highlighting the threats Ohio’s budget poses to Medicaid expansion within HB 96. This is identified by the “kill switch” to mental health services and “runaway spending.”
Since 2019, Medicaid spending has increased from $26.8 billion in 2019 to an estimated $51.1 billion in 2027. Usually, increases in caseload are the main driver of spending, however, this is not the case. In fact, the caseload decreased in this budget—and in the previous budget—but spending increased substantially. According to Moody’s testimony, the main driver of spending in this budget are projects in Medicaid departments, state share expansion to refill one-time federal funds, and increases to provider rates. Moody shared his concern that relying too much on one-time federal dollars and provider rate increases can lead to further challenges with the budget. He ended his remarks by reiterating the importance of Medicaid as a health program that assists people live healthy lives and thrive in Ohio.
Conclusion
Director Corcoran and Greg Moody provided testimony on the Medicaid program in Ohio, detailing the substantive activity that has occurred in the program’s past, present, and projected future. With an understanding of the program and its responsibility to care for and bolster health services in Ohio, it becomes even more relevant for legislators to develop a sensible budget that takes into consideration the 3 million Ohioans currently enrolled in the program.
