Ohio Medicaid Enrollment Drops Amid National Post-Pandemic Unwinding

Data from the Kaiser Family Foundation (KFF) indicates that over 600,000 Ohio residents have been disenrolled from the state's Medicaid program between March 2023 and April 2025. This reduction is part of a nationwide 'unwinding' process following the expanded Medicaid coverage during the COVID-19 pandemic. Despite the large drop, Ohio's Medicaid enrollment remains 8% above pre-pandemic levels from February 2020, reflecting the impact of expansions under the Affordable Care Act (ACA).

The unwinding began in March 2023, when federal rules allowing states to disenroll individuals no longer eligible for Medicaid came into effect, ending the prior requirement to maintain enrollment regardless of eligibility changes. This process has led to significant fluctuations in Medicaid enrollment across states, with populous states experiencing the highest decreases.

Concerns have emerged regarding the unwinding procedure, as administrative challenges have resulted in some eligible individuals being removed from coverage. In Ohio, while some of those disenrolled may have transitioned to employer-based insurance, a notable portion could have become uninsured, raising issues around access to affordable healthcare.

Further changes to Medicaid stemming from recent legislative actions, including budget bills with provisions for work requirements and funding cuts, have heightened apprehensions about the stability of Medicaid coverage. These concerns are particularly acute for vulnerable populations and residents in rural areas where healthcare facilities face financial pressures.

Healthcare experts warn that reductions in Medicaid coverage can lead to increased uncompensated care for providers, financial hardship for low-income individuals, adverse mental health outcomes, and potentially higher mortality rates. The ongoing disenrollment trends underscore the importance of monitoring the impact on health outcomes and healthcare infrastructure as Medicaid enrollment fluctuates post-pandemic.