Over 500,000 fewer Ohioans are benefiting from public health care than two years ago, due to the expiration of COVID-era safeguards on coverage. According to the health care research firm KFF, the number of those enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) in Ohio has fallen from over 3.4 million to under 2.9 million between March 2023 and October 2024. This 16 percent decline aligns with the drops seen across the country since the beginning of the nationwide “unwinding process” following the end of the public health emergency.
Although Ohio still has significantly more residents enrolled in the two programs compared to pre-pandemic levels, the recent decline is concerning, as research suggests that many have lost coverage due to procedural issues rather than ineligibility. From February 2020 to March 2023, the “continuous enrollment” provision in the Families First Coronavirus Response Act prevented states from conducting Medicaid redeterminations. This allowed enrolled individuals to retain their coverage without completing regular eligibility reviews.
Consequently, Medicaid and CHIP enrollment in Ohio grew from just under 2.6 million to over 3.4 million by the time the provision ended, a 32 percent increase, mirroring the trend observed nationwide.
Decline in Ohio Medicaid coverage
While some of the 500,000 individuals removed from the programs in Ohio were likely deemed ineligible, research indicates that many lost coverage due to factors beyond their control.
Surveys conducted by KFF found that many individuals were unaware of the implications of the unwinding process, including whether states would automatically remove them and what steps they needed to take to maintain their coverage. KFF has also highlighted the problem of “procedural” disenrollments, where individuals may have still been eligible for public health care but were removed due to administrative mistakes, delays in receiving renewal notices, or issues with processing forms. Ohio was one of nine states to receive a letter in late 2023 from the U.S. Department of Health and Human Services (HHS), which expressed concern about the high child disenrollment rates.
The agency completed an audit of Ohio’s redetermination process, published in 2024, and estimated that Ohio had incorrectly renewed or terminated around 6 percent of Medicaid enrollees. As a result of the increases in coverage that occurred over the course of the pandemic, KFF found that there are now roughly 11 percent more Ohioans enrolled in Medicaid or CHIP than before February 2020. Ohio, like all states, has largely completed its unwinding process.
Consequently, KFF will no longer be updating its Medicaid and CHIP disenrollment tallies.