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Every Ohio State Senate district is home to a minimum of 10,000 constituents who have health coverage thanks to Medicaid expansion. The 770,000 Ohio adults currently enrolled in Medicaid expansion would have their health coverage immediately cancelled if the federal government makes changes and the state Senate does not remove harmful “trigger language” from the state budget.
Between 10,000 and 44,500 constituents in each Senate District rely on Medicaid expansion
Using March 2025 data from the Ohio Department of Medicaid’s public dashboard, Community Solutions produced estimates of the number of constituents covered by any type of Medicaid and then also Medicaid expansion for each of Ohio’s 33 State Senate Districts and 99 State House Districts. As the map below shows, between 10,000 and 44,500 constituents in each Senate District rely on Medicaid expansion, representing between 3 percent and 13 percent of the district’s population.
The 770,000 Ohio adults enrolled in Medicaid expansion will immediately lose coverage if the federal government makes changes and the Ohio Senate does not remove harmful “trigger language” from the state budget.
The district with the fewest number and share of people covered by expansion includes both wealthier Delaware County and Holmes County where half of the population is Amish. Amish people generally do not participate in Medicaid due to their beliefs. The highest number covered by Medicaid expansion live in districts covering northern Franklin, northern Cuyahoga, and eastern Hamilton counties.
Download a printable version of the Medicaid maps and tables
State Senate District Medicaid Expansion
State House District Medicaid Expansion
Medicaid expansion in Ohio is at risk
Following adoption of the Affordable Care Act, the Supreme Court ruled that the choice to expand Medicaid would fall with the states. In 2014, Ohio adopted Medicaid expansion with bi-partisan support. This allowed all working adults to enroll in Medicaid coverage if they earned less than 138 percent of the federal poverty level ($21,597 for a single person in 2025), even if they did not have children, and provided coverage for working parents between 90 percent and 138 percent of the federal poverty level (from $23,986 to $36,777 for a family of three).
For the past decade, Medicaid expansion has been a 90/10 split, with the federal government covering 90 cents of every dollar and the state responsible for 10 cents in this cost-sharing agreement. The US Congress is eyeing a reduction in the federal share as part of larger conversations about budget reconciliation.
The Ohio House added language about studying the issue if the federal government cuts their matching percentage, but the House failed to change “shall” to “may.”
Unless it is amended, state budget language removes Ohio’s flexibility related to Medicaid expansion, eliminating Group VIII as an eligibility category if the federal government adjusts the cost-sharing arrangement by even one cent. The Ohio House added language about studying the issue if the federal government cuts their matching percentage, but the House failed to change “shall” to “may.” The harsh trigger remains.
Nearly 770,000 constituents are counting on their Senators to fix this issue.
New Ohio Medicaid by county fact sheets
More than 3 million Ohioans receive health coverage from Medicaid, representing 25.6% of the state’s population.
The largest group of total Medicaid enrollees are adults aged 19 - 44. The next largest group of enrollees are children aged 6 - 18. Taken together, the greatest impacts are felt by working adults and Ohio families.
Current Ohio Medicaid Expansion enrollment includes 769,520 adults. Ohio’s uninsured rate is half of what it was before Medicaid expansion in 2014.
Medicaid work requirements for the expansion population could see far reaching impacts if implemented. Statewide nearly half of residents with Medicaid Expansion coverage are already working. Others are students, caretakers, or dealing with a chronic health condition.
