10/16/2025

Ohio Policy Summit Projects Ohio’s Medicaid Future

At the Health Policy Institute of Ohio (HPIO) Summit on October 9, 2025, state experts examined the far-reaching effects of federal HR1 on Medicaid coverage and funding. The discussion highlighted growing concern for aging services providers and older Ohioans as states prepare for changes to eligibility, coverage, and reimbursement structures.

A provision in Ohio’s House Bill 96 would have automatically ended the state’s Medicaid expansion if the federal contribution rate dropped below a certain level. While that threshold was debated during HR1’s passage, the measure did not immediately reduce Ohio’s federal match. Still, the Kaiser Family Foundation (KFF) projects that HR1 will cut $1 trillion in federal Medicaid funding nationally over the next decade—about $33 billion of that loss expected in Ohio.

At the Summit, Jennifer Tolbert, KFF’s director of state health reform, said HR1’s Medicaid work requirements could result in 5.3 million more Americans without coverage by 2034, including an estimated 330,000 Ohioans. She identified new eligibility restrictions, added cost sharing, and limits on how states direct payments to providers as key concerns.

Adam Searing of Georgetown University’s McCourt School of Public Policy warned that HR1’s Rural Transformation Fund—a $50 billion initiative managed by the Centers for Medicare & Medicaid Services—could create pressure on states to pass politically favorable laws to compete for funding.

Other Summit speakers highlighted Ohio’s recent announcement of becoming the thirteenth Age-Friendly state in the country, as well as a forecast for the State Plan on Aging which is currently being developed. LeadingAge Ohio board member Ann Conn of the McGregor Foundation in Cleveland, Ohio, presented on two promising models: affordable assisted living and the Program for All-inclusive Care for the Elderly (PACE).