Ohio has seen an increase in the number of children without health insurance since the unwinding of pandemic-era Medicaid continuous coverage. From 2022 to 2024, about 30,000 more children became uninsured.
The rate of children without health coverage has hit a decade-long high nationwide, according to a Georgetown University analysis of data from the Census Bureau’s American Community Survey. Ohio is among 22 states that have seen a statistically significant increase in uninsured children.
“These numbers are really a wake-up call for elected officials that it's time to roll up their sleeves and try to figure out what's gone wrong here,” said Joan Alker, the executive director of the Center for Children and Families at the Georgetown McCourt School of Public Policy.
The so-called Medicaid unwinding
Alker attributes the rising rate of uninsured children to the redetermination of Medicaid eligibility after pandemic-era coverage mandates expired – a process often referred to as Medicaid unwinding.
“Unfortunately, that was a tough process. We were very worried that in states that didn't do a super careful job, we would lose children who should have remained on Medicaid. I think that is what's driving this increase,” she said.
The result has been Ohio’s rate of uninsured children rising from 4.5% to 5.6%, sitting slightly below the national average. Around 152,000 children in Ohio lacked health care coverage in 2024.
“The uninsured rate for children went up in 2024, and that was not true for adults. So children were hit harder by the Medicaid unwinding,” she said.
‘Dark clouds’ ahead
Alker warned the trend will only grow as Medicaid faces major federal budget cuts, beginning in 2027.
“There's nothing more important for children than Medicaid,” Alker said. “And so, by exacting these kinds of huge cuts, there's no way to spare children some harmful impacts.”
Other federal policies could also deepen the problem, Alger said, including proposals to end enhanced tax credits in the Affordable Care Act marketplace and deportation policies that could discourage immigrant families from enrolling their children in coverage.
“Those are just two examples of reasons why we think the uninsured rate is gonna continue to go up for children even before we get to the huge cuts,” she said. “So it's a bleak outlook.”
Why it matters
Without insurance, health care often becomes too expensive, Alker said.
Children are regular users of health care, receiving immunizations, check ups and treatment for common conditions, like asthma. If they lack coverage, Alger said many families will struggle to get the preventative care they need.
“If you're uninsured, that raises the barriers to getting (preventative) medications. The child's more likely to wind up in the emergency room, having a crisis, which is expensive. It's traumatic, it inhibits them from going to school, it just has a whole cascading effect, which ends up being much more costly for the family and for society at large.”
