Ohio's Uninsured Child Rate Rises as Federal Plan Rejected

The number of uninsured children in Ohio has increased by 30,000 between 2022 and 2024, bringing the state's total to 152,000. This development coincides with the federal government's rejection of a state proposal to provide continuous health coverage for young children from birth through age four.

A Sharp Increase in Uninsured Children

A recent report from Georgetown University highlights a concerning trend in Ohio's child healthcare landscape. According to the study, the state is one of 22 in the nation to see a statistically significant rise in the rate of uninsured children over the past two years.

Between 2022 and 2024, the number of children without health coverage in Ohio grew by 30,000. This surge has pushed the total number of uninsured minors to 152,000. This figure represents 5.6% of all children in the state.

Experts attribute this increase primarily to the conclusion of federal pandemic mandates. These rules had previously prevented states from removing individuals from Medicaid rolls. Since the mandates lifted in 2023, the Ohio Department of Medicaid has been reassessing eligibility for its 3.5 million beneficiaries, resulting in more than 600,000 people losing coverage.

Federal Government Denies Continuous Coverage Plan

As Ohio began the process of reviewing Medicaid eligibility, state lawmakers initially sought to protect its youngest residents. The 2023 state budget included a provision requiring the Department of Medicaid to seek a federal waiver for a new policy.

The proposed policy would have provided continuous health coverage for children from birth until their fourth birthday, regardless of changes in their family's income during that period.

“Ohio had proposed to keep kids enrolled through their fourth birthday, so that no matter what happened with their family’s income, they would just be continuously enrolled, from birth through their fourth birthday, if they qualified at birth,” explained Emily Campbell, CEO of the Center for Community Solutions, a Cleveland-based think tank.

However, the federal government ultimately rejected this and similar requests from other states. On July 17, the Centers for Medicare and Medicaid Services (CMS) announced a policy shift away from waivers that extend coverage beyond statutory limits. The agency stated the change was part of its commitment to "using taxpayer dollars carefully."

Reasons Behind the Coverage Losses

Health policy experts suggest that many children may have lost coverage due to procedural issues rather than ineligibility. The massive task of redetermining eligibility for millions of people has placed a significant strain on government agencies.

Joan Alker, executive director of the Georgetown Center for Children and Families, which produced the report, expressed concerns about the process. “We were very worried about eligible children being disenrolled by mistake during this unwinding process,” she said.

Campbell noted that county Job and Family Services offices, which are responsible for the eligibility reviews, are often understaffed. This can lead to errors and delays. “Any time that there is a change in public policy or regulation, it always takes state and local government some time to be able to work through all of that, and it’s added work,” she commented.

Confusion Over Eligibility Thresholds

A key factor contributing to accidental disenrollment is the difference in income limits for adults and children. The Children’s Health Insurance Program (CHIP) has a much higher income threshold than adult Medicaid programs.

This disparity can lead to confusion for families. Parents who are notified that they no longer qualify for their own Medicaid coverage may mistakenly assume their children are also no longer eligible.

• CHIP (Children): Covers families earning up to 200% of the federal poverty level, which is $64,300 for a family of four.
• Medicaid Expansion (Adults): Covers adults in families earning up to 138% of the poverty level, or $44,367 for a family of four.
• Medicaid (Parents/Caretakers): Covers adults in this category earning up to 90% of the poverty level, or $28,935 for a family of four.

“So, if the parents lose their Medicaid coverage, they don’t always realize that their kids can maintain that coverage,” Campbell stated. “We do see kids getting wrapped up with their whole families because, of course, we operate in families.”

The rejection of the continuous coverage plan means that families must continue to navigate this complex system, and thousands of young children in Ohio remain without the stable health insurance coverage the state had initially sought to provide.