In a swift move, Ohio has disenrolled a staggering 600,000 people from its Medicaid program over the past couple of years, according to data from KFF, a nonprofit dedicated to health policy research.
This change has been facilitated by what the state refers to as the “unwinding process,” which is taking place nationwide as a result of the temporary enhancements to Medicaid coverage made during the COVID pandemic.
The Ohio Department of Medicaid (ODM) commented on this shift, stating to Newsweek: “The unwinding process illustrates that the additional benefits and eligibility established during the pandemic were meant to be temporary.”
The ODM noted that there was a dramatic increase in enrollment—over 800,000 individuals—due to pandemic-related circumstances between March 2020 and February 2023. Consequently, a decrease was anticipated as states reverted to their original Medicaid enrollment rules.
Importance of This Change
This unwinding trend is resulting in substantial drops in Medicaid enrollment across the country. The declines vary significantly by state, with densely populated regions seeing millions removed from the program. In contrast, some states are experiencing smaller yet still concerning reductions.
Health experts and policymakers have raised alarms about the mounting number of Americans without health coverage. They warn that the rescinding of benefits following significant changes, like those proposed in President Trump’s budget bill affecting the Medicaid program, could severely impact health outcomes and increase medical costs.
Key Statistics
To provide context, there were approximately 3,421,792 individuals enrolled in Ohio’s Medicaid program as of March 2023, but this number plummeted to 2,802,277 by April 2025, as per KFF data.
Despite the significant decrease of more than 600,000 recipients, enrollment remains over 8% higher than pre-pandemic figures from February 2020, when 2,596,917 were covered under the state’s Medicaid plan.
Similar patterns in Medicaid enrollment trends can be observed across the nation. During the pandemic, certain states expanded the federal program under the Affordable Care Act (ACA), shielding individuals from disenrollment changes due to shifting eligibility rules. Federal guidelines mandated that states keep program members enrolled until March 2023, after which states were free to begin unwinding.
However, there are growing concerns regarding how states have managed this disenrollment process, with accusations that many individuals who remain eligible are being dropped due to the complexities of proving their ongoing suitability.
According to Timothy McBride, a public health professor at Washington University in St. Louis, “the variation in disenrollment rates depends largely on how effectively each state manages the program.” He further explained that some states have struggled with implementing seamless verification processes, leading to what experts describe as “procedural determinations.”
This means individuals are losing their coverage not because they don’t qualify, but because of inefficiencies in processing their documentation—be it lost mail or failure to comply with complicated requests.
Many of those disenrolled from Medicaid in Ohio might transition to other forms of insurance, like employer-funded plans. Yet, a significant number are being left uninsured amidst growing concerns regarding access to affordable healthcare—particularly for the state’s more vulnerable citizens in rural areas, where the threat of hospital closures is imminent.
Voices on the Matter
The ODM informed Newsweek: “At the end of the pandemic, following the Consolidated Appropriations Act of 2023, we initiated the Unwinding strategy in April 2023. During the ensuing 13 months, over 3.5 million Medicaid members in Ohio had their eligibility re-evaluated, which is reflected in the statistics discussed in the KFF report regarding the end of constant coverage available during the health emergency.”
“We’ve collaborated with local partners and communicated effectively to ensure members are aware of their options to maintain coverage and to facilitate a smooth transition while continuing to provide necessary health services. Ohio is recognized for executing federal guidelines efficiently, completing the unwinding process timely, and avoiding compliance actions.”
Bruce D. Meyer, a professor at the University of Chicago, expressed to Newsweek: “As hospitals increasingly face financial strain due to rising uncompensated care, low-income individuals will endure greater financial stress, and related issues like depression and mental health challenges are likely to escalate. Most alarmingly, states with significant Medicaid cuts might witness a rise in adult mortality rates.”
The Road Ahead
As the unwinding process progresses, further declines in enrollment are probable, posing serious questions about how this increase in the uninsured population will affect health analytics and access to care.
Update 8/8/25, 10:52 a.m. ET: This article now includes comments from the ODM and Timothy McBride.
