Report: Medicaid rule changes threaten Ohio mental health care

By Farah Siddiqi

Beginning in 2027, many Ohioans on Medicaid will have to meet new federal work reporting requirements to keep their health coverage.

A new report warned the rules could disproportionately affect people with mental health conditions, who already face barriers to steady employment. According to the National Alliance on Mental Illness, about 575,000 Ohio adults live with a serious mental illness, and more than four in 10 statewide have reported symptoms of anxiety or depression.

Deborah Steinberg, senior health policy attorney for the Legal Action Center, said while there are exemptions for those with disabling mental disorders, many people fall through the cracks without a formal diagnosis.

"How can we get more people diagnosed?" Steinberg asked. "One of the things would be to increase access to universal screening, making sure there are more opportunities for people to get screened for a mental health condition."

In Franklin County alone, roughly 13% of adults said they have had 15 or more poor mental health days in the past month. The new law will require most adults on Medicaid to prove they work or volunteer at least 80 hours a month to maintain their coverage. It is estimated millions could lose coverage nationwide due to paperwork and reporting hurdles.

Steinberg pointed out exemptions alone will not prevent widespread losses in care and warned the changes could ripple through local health systems.

Nathan Boucher, a research health scientist at Duke University, said hospitals depending on Medicaid could face major setbacks.

"My concern is that not just individuals will be hurt by this but the hospitals will be hurt by this because they will have a degraded mechanism for which to bill for a lot of these patient care services," Boucher explained.

In Ohio, Medicaid covers more than 3.3 million residents, including about one in four adults with behavioral health needs, according to the state. Their advocates said the state’s response will determine how many people with mental health challenges stay covered once the new work reporting rules take effect.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.