DeWine leaves door open for Ohio to end Medicaid expansion if federal funding drops

By Anna Staver / July 2, 2025

COLUMBUS — As Congress debates Medicaid cuts, Gov. Mike DeWine has left the door open for Ohio to drop coverage for more than 770,000 people.

The governor kept trigger language in the state’s operating budget that will require Ohio to end Medicaid expansion if the federal government reduces its share of funding.

“We want to be able to continue coverage,” DeWine told reporters Tuesday. “We hope we are able to continue coverage.”

But when asked about the automatic trigger, DeWine dodged.

“Let me answer it this way,” he said. “I had the opportunity to appoint Jon Husted to the United States Senate. He is someone who has a deep background and understanding in Medicaid.”

That same wariness is tripping up Republicans in Congress as they try to pass President Donald Trump’s One Big Beautiful Bill Act.

Conservatives in states that expanded Medicaid under the Affordable Care Act appear hesitant to roll it back—especially when doing so could shutter rural hospitals already on the brink.

Congressional Republicans have gone back and forth on Medicaid expansion—the people made eligible for health coverage under the Affordable Care Act, commonly known as Obamacare.

In Ohio, more than 770,000 people get health insurance through expansion. It’s what allows low-income adults—many without children—to see a doctor, fill prescriptions and get mental health care.

Hospitals say expansion has made a difference, too.

In states that expanded Medicaid, hospitals reported far fewer unpaid bills, with uncompensated care costs making up just 2.7% of their expenses. In states that didn’t expand, that number was 7.3%, according to a 2023 federal Medicaid and CHIP Payment and Access Commission report.

But keeping that coverage comes with a price.

Right now, the federal government picks up 90% of the cost for Medicaid expansion, a much higher share than it pays for traditional Medicaid. In Ohio, expansion is estimated to cost $8.4 billion in fiscal year 2026, but Ohio will pay $840 million—unless the federal government makes changes.

Congressional Republicans want to lower their share of Medicaid expansion to help cover the costs of extending President Donald Trump’s 2017 tax cuts. Trump has also proposed eliminating taxes on tips and expanding the child tax credit, which would add even more costs if passed.

The Kaiser Family Foundation estimated reducing the federal share from 90% to 80% would save about $626 billion nationally, while dropping it down to the typical Medicaid match rate could save as much as $1.7 trillion.

Florida Republican Sen. Rick Scott had proposed ending the federal 90% funding match for new Medicaid expansion enrollees at the end of 2030. But Politico is now reporting that Scott has withdrawn the amendment.

An amendment from Maine Republican Sen. Susan Collins to give more money to rural medical providers failed to pass as well.

Still, what Congress ultimately decides when it comes to Medicaid cuts will leave states like Ohio with a difficult choice: Find more money or cut services.

It’s a choice Ohio Democrats said they saw coming.

“The way to prepare for federal cuts was to fund those programs through the state budget,” House Minority Leader Dani Isaacsohn, a Cincinnati Democrat, said after the budget passed.

He argued that Ohio’s GOP supermajority could have stepped up but instead chose $1.14 billion in income tax cuts that will largely benefit wealthy Ohioans.

Westlake Democratic Rep. Bride Rose Sweeney said this was by design. She believes Ohio Republicans lowered income taxes and took $1.7 billion from unclaimed funds in order to blame federal lawmakers when Ohio makes program cuts.

“They are not dumb; they are intentional. They know what is coming. And what happened here today is going to allow them to try to make the excuse that we have no money in this state. It’s not us. Those are the feds,” Sweeney said. “And I want to say it loud and clear that because of the vote today, our Republican colleagues are culpable in any cuts that come down from the federal government.”

Democrats backed DeWine’s veto to keep continuous Medicaid coverage for children ages 0 to 3.

Republicans ended that coverage in the budget, but DeWine reversed it, along with a separate plan to block SNAP recipients from using their benefits to buy candy and soda.

DeWine said he supports restricting SNAP purchases and plans to seek a federal waiver, but he called the budget’s approach overly complex.