Gov. Mike DeWine on Friday acknowledged the challenge, warning that looming federal reductions to Medicaid funding could cost the state an estimated $33 billion over the next decade. “We have some tough decisions ahead,” DeWine said during a press briefing. “The expiration of these federal supports will have a real impact on our ability to maintain access to care for the most vulnerable.”
The enhanced ACA tax credits—first expanded under the American Rescue Plan Act of 2021 and extended through subsequent legislation—have helped millions of Americans afford health insurance through federal marketplaces. Without congressional action, the subsidies will lapse at the end of the year, leading to higher premiums starting in 2027.
Health policy experts warn that the combined effect of lost ACA credits and Medicaid cuts could widen coverage gaps, particularly in rural and low-income communities. “We’re bracing for a wave of uninsured patients,” said Maria Thompson, policy director for the Ohio Association of Community Health Centers. “Many families simply won’t be able to afford their current plans.”
State lawmakers are expected to debate potential measures to offset federal shortfalls when the new legislative session convenes this month, but DeWine’s office has given few details about possible remedies. Some advocates are urging the administration to expand state-funded subsidies or explore public-private partnerships to sustain coverage levels.
“This is going to test Ohio’s commitment to health equity,” Thompson said. “We can’t afford to lose the progress we’ve made over the past decade.”
