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Providers and advocates warn Ohio Senate that trigger language could strip health care from 770,000 people
Summary
Health care advocates, rural hospitals and social-service groups told the Senate Medicaid Committee that House Bill 96 language tying state coverage to federal funding levels would abruptly end Medicaid expansion for roughly 770,000 Ohioans and damage hospitals, behavioral-health services and community providers.
Members of the Ohio Senate Medicaid Committee heard unified testimony on May 8 from providers, advocates and legal-aid lawyers urging lawmakers to remove so-called trigger language in House Bill 96 that would terminate Medicaid expansion if the federal Medicaid assistance percentage (FMAP) drops below a set level.
The warning was stark: removing expansion would immediately cut coverage for about 770,000 Ohioans and could push rural hospitals and community providers into crisis. "This provision threatens to dismantle a health-care system that has steadily improved the lives of those nearly 800,000 Ohioans," said Brandy Kesey, health and public benefits attorney at Advocates for Basic Legal Equality.
Supporters of expansion told senators the policy shape and the budget are interdependent. Catherine Poe, a health-and-budget researcher at Policy Matters Ohio, told the committee the proposed trigger would force local decisions into a federal box and would shift risk to hospitals and small providers. "Eliminating the expansion category would also create a coverage gap when an individual's income is too low to qualify for coverage on the health insurance exchange, but too high to qualify for Medicaid," she said.
Multiple witnesses described immediate operational impacts if expansion were ended. Jared examples included: a 55-year-old rural caregiver who would lose access to care that keeps her able to look after her adult son; students and low-wage workers who rely on expansion for medications and chronic-care follow-up; and rural hospitals that depend on Medicaid reimbursement to stay solvent. "Hospitals will lose critical reimbursements for uninsured patients, forcing them to either drastically cut services, cut staffing levels, or shut down entirely," Kesey said.
Advocates urged the Senate to change the language from an automatic "shall" to a more flexible "may" or to adopt a glide-path approach that would give state lawmakers time to plan if federal funding changes. Tara Britton of the Center for Community Solutions said other states have adopted softer trigger language and urged Ohio to do the same so lawmakers retain local control.
Senate staff and county officials also raised process concerns. John Honeck, executive director of the Ohio Job and Family Service Directors Association, said counties perform eligibility work and that sudden policy shifts would impose large administrative burdens on already stretched local offices.
The committee paused without acting. Several witnesses asked senators to delay any automatic cuts and allow time for contingency planning and targeted solutions that would avoid large coverage losses, particularly in rural and underserved communities.
If lawmakers do not alter the trigger language, advocates said, the consequences will be immediate and measurable: loss of coverage for hundreds of thousands of Ohioans, reduced patient access to behavioral health and maternal-health programs, and a financial shock to safety-net hospitals.
Senators signaled they were considering alternatives but took no vote at the hearing. The committee scheduled further public testimony on the budget the following week.
