COLUMBUS, Ohio — The state estimates that 750,000 Ohioans would lose coverage if its expansion of
Medicaid is phased out under the Republican plan backed by President Donald Trump to replace Obamacare.
The plan would eliminate federal funding incentives that provided for expansion under the Affordable Care
A phase-out of Ohio’s expansion would reduce Ohio Medicaid spending by $37 billion between 2018 and 2026
and decrease the state share of that spending by $3.7 billion, according to estimates provided Thursday
by state officials about the potential effects of the Republican plan.
The state estimates that two alternative scenarios wouldn’t take as many people off the rolls or cut Ohio
Medicaid spending as much but would increase the state’s share of the cost.
Ohio could keep expanded Medicaid access without the enhanced federal funding match, meaning an estimated
123,000 Ohioans would lose coverage, or it could restrict expansion eligibility to people with a lower
income level than outlined in the ACA, meaning an estimated 284,000 would lose coverage.
Republican Gov. John Kasich has pleaded for Medicaid expansion to be maintained, saying it provides
needed health insurance protection for many people.
Officials said Thursday that the estimates released by the state will stand as the Kasich
administration’s comment on the Congressional Budget Office’s analysis of the Republican plan.
The analysis of the plan by the nonpartisan Congressional Budget Office found that 14 million people
nationwide — about 500,000 Ohioans among them — would lose health care coverage in the first year, and
24 million in all by 2026.
Even some conservatives are skeptical of the plan, and Trump has indicated he’s open to negotiation in
his first attempt working with Congress.
The Republican proposal also would change how the federal government pays states for the Medicaid
program, calculating on a per-capita basis with a set limit. The state estimates that Ohio Medicaid
spending initially would be under that cap but would exceed it by 2025 without more flexibility to
manage the spending.