Governor Mike DeWine’s proposed state budget includes a provision that could impact Medicaid coverage in Adams County and across Ohio. The budget contains a clause that would automatically end Medicaid expansion in the state if the federal government reduces its share of funding for the program.
The language in the budget bill, currently under review in the Ohio House of Representatives, would “immediately discontinue all medical assistance” for those covered under Medicaid expansion should federal funding drop below the current 90% level. This type of provision, known as a “trigger law,” has been adopted in nine other states, including Indiana, Virginia, and North Carolina.
Medicaid expansion, first implemented in Ohio in 2013, extended coverage to individuals who previously did not qualify under traditional Medicaid. The federal government currently covers 90% of the costs for this group, with the state responsible for the remaining 10%. Congressional discussions in Washington, D.C., include potential changes to Medicaid funding, prompting Ohio lawmakers to include the trigger clause in the proposed budget.
Ohio Budget Director Kim Murnieks addressed the provision during an Ohio House Medicaid Committee hearing, stating, “We have constructed this budget based on the parameters, the Medicaid laws, rules, and regulations as they exist today. Should they change, we obviously need to work to pivot.”
The budget bill is expected to undergo amendments before it reaches a final vote, with changes likely before the end of June.
According to state data, approximately 771,000 Ohioans are covered under Medicaid expansion. In Adams County, where Medicaid covers 25.1% of the population, any change to the program could affect local services. Based on the 2020 census, this equates to more than 6,800 county residents currently receiving coverage under Medicaid.
The Ohio Legislative Services Commission reported that Medicaid spending in Adams County for fiscal year 2024 totaled $68.2 million. Additionally, the Adams County Department of Job and Family Services, which administers benefits and other public assistance programs, received nearly $47.9 million in state funding for services.
Beyond the trigger provision, the DeWine administration is also pursuing work requirements for Medicaid expansion recipients. If implemented, state projections estimate that approximately 60,000 individuals could lose coverage due to noncompliance with the new employment criteria.
As the state legislature continues budget negotiations, the final outcome of Medicaid-related provisions will depend on amendments made in both the Ohio House and Senate in the coming months.
