When President Donald Trump signed the One Big Beautiful Bill Act into law in July 2025, experts estimated it would lead to $1 trillion in cuts to Medicaid over the course of a decade. They say that the cuts are intended to offset tax breaks for the wealthy and that changes to the program will leave many Americans without health insurance.
The budget law imposes new work requirements on Medicaid enrollees, requiring adults ages 19–64 to spend 80 hours a month in a job or job training program or community service and to recertify their eligibility for the program every six months instead of annually.
According to a report published in May by Protect Our Care, a healthcare advocacy group, Ohio is facing $33 billion in federal cuts to Medicaid over the next decade, with around 300,000 recipients losing their benefits over the next decade.
Ohio Democratic state Rep. Anita Somani told the Ohio Independent that work requirements simply make it more difficult for those who need Medicaid to keep their coverage.
“When you put work requirements in place, what it does is it just creates more hurdles, and people end up just giving up, and they just lose their health care,” she said.
Researchers project the paperwork burden and more frequent recertification of eligibility could push between 5 and 10 million people off Medicaid by 2028.
Somani, who works as an obstetrician-gynecologist at OhioHealth in Columbus as she serves her second term representing Ohio’s 8th House District, said many of her patients on Medicaid or whose children are on Medicaid do work, sometimes two or three jobs.
“So, it’s the idea that we’re giving a handout to lazy people, but the reality is every one of those people who are working on Medicaid, in order for them to meet those work requirements, that means taking time off, maybe an hourly wage job or finding childcare to be able to go in during working hours,” Somani said. “So it’s not a sustainable program, and with the cuts that we’ve made, there’s not enough staffing in the Medicaid offices for all of this increased workload for them.
“So, I think people will fall through the cracks, or they’ll just decide it’s not worth it, and then they’ll go to the emergency room when they’re sick, which, again, increases healthcare costs, you know, all around,” she said. “I think we’re missing the idea that healthcare should be a right, not a privilege. And this Big, Beautiful Bill is creating the idea that healthcare is a privilege now.”
Ellen Taverna is the national director of federal and state Medicaid policy at The Arc, a nonprofit advocacy group for those with intellectual and developmental disabilities and their families. She told the Ohio Independent that Medicaid is more than simply healthcare insurance.
“It’s about allowing independence and community living to be possible,” Taverna said. “It’s also about families and around paid family caregiving as well being under threat. … This is about supporting families and allowing them to support their own loved ones in their homes.”
In March, Republican state Rep. Josh Williams introduced House Bill 795, which would increase penalties for Medicaid fraud. A second version of the bill added a provision that would have banned “a spouse, parent, child, grandparent, grandchild, great-grandparent, great-grandchild, brother, sister, aunt, uncle, nephew, niece, cousin, or a step-relation of an individual enrolled in a Medicaid waiver component from receiving Medicaid payment for providing personal care services covered under the waiver component,” according to the Ohio Legislative Service Commission.
In June, The Arc of Ohio and disability advocates organized against the provision.
“What we were able to see in Ohio is that when that was threatened — that this is, like, the backbone of our our care system — that when Ohioans saw that this was possibly taking away the funding, that they were able to to demonstrate how much that family caregivers do,” Taverna said, adding, “They’re preparing meals, managing medication, bathing, dressing, managing medical appointments.”
Republican lawmakers on the state House Medicaid Committee reversed course on the bill after hearing from caregivers and removed the provision from the bill, which remains in committee.
“This conversation that we’ve seen that’s sort of beginning and ending with fraud allegations is not what actually Medicaid’s about, and we want to make sure that the focus continues to be around the benefits of Medicaid, which includes healthcare, home- and community-based services, personal care assistance, behavioral health services, employment supports, transportation supports — all those things that are helping people live in their communities, their homes, outside of nursing homes and institutions, and attending schools and staying healthy and participating meaningfully in their communities,” Taverna said.
