Medicaid in Ohio
Ohio expanded Medicaid under Governor John Kasich in 2014. Adults aged 19-64 with income up to 138% FPL (about $22,025 for a single person, or $45,540 for a family of four, for 2027 coverage) qualify. There is no asset test. Nearly 770,000 Ohioans were enrolled through expansion as of early 2025.
New federal work requirements apply to expansion adults. States must start them by January 1, 2027 (a state making a good-faith effort can get extra time). Most expansion enrollees ages 19 to 64 will need to show 80 hours a month of work, school, job training, or community service. Parents of children under 14, pregnant people, people who are disabled or medically frail, and some others are exempt. Watch for notices from Ohio Medicaid or your county Job and Family Services.
Apply through benefits.ohio.gov or your county Job and Family Services office. Enrollment is year-round.
One uncertainty to watch: Ohio's proposed 2026-2027 state budget included language that would discontinue Medicaid expansion if the federal matching rate (FMAP) drops below 90%. The federal government currently pays 90% of expansion costs. If Congress reduces that rate as part of broader budget negotiations, Ohio's expansion could be at risk. This hasn't happened yet, but it's worth monitoring.
The marketplace
For Ohioans with income above 138% FPL, the ACA marketplace through HealthCare.gov is the main option for subsidized individual coverage. About 470,000 Ohioans picked a marketplace plan during 2026 open enrollment, according to CMS.
Premiums rose about 30% on average before subsidies for 2026, and they went up again for 2027. Here is the benchmark (second-lowest cost Silver) premium for a 40-year-old before subsidies, from HealthCare.gov plan data:
- Franklin County (Columbus): about $607 per month, up from $528 in 2026
- Cuyahoga County (Cleveland): about $595, up from $489
- Hamilton County (Cincinnati): about $544, up from $483
- Montgomery County (Dayton): about $627, up from $526
- Lucas County (Toledo): about $626, up from $515
- Athens County (southeast Ohio): about $828, up from $617
After subsidies, the impact depends on income. People with low incomes still have access to very affordable plans, often including $0-premium Bronze options. The enhanced tax credits expired after 2025 and were not renewed, so for 2027 people above 400% FPL ($63,840 for a single person, $132,000 for a family of four) get no premium tax credit and face the full increase.
Carriers in Ohio (2027)
CareSource, Molina, and Paramount left the Ohio marketplace after 2026, and AmeriHealth Caritas Next joined. If you had CareSource, Molina, or Paramount, you need to pick a new plan. Eight insurers sell plans for 2027:
- Anthem Blue Cross Blue Shield sells plans in all 88 counties and has extensive provider networks.
- Medical Mutual of Ohio (MedMutual) is a legacy Ohio insurer that sells plans statewide for 2027, with strong brand recognition and broad networks, especially in Northeast Ohio.
- Ambetter (Centene/Buckeye Health Plan) sells plans in 72 counties and often competes on price.
- Oscar Health sells plans in 73 counties through two Oscar companies, including all the major metros.
- Antidote Health Plan of Ohio sells plans in 51 counties, including Columbus, Cleveland, Cincinnati, Dayton, and Toledo.
- UnitedHealthcare sells plans in 42 counties.
- AmeriHealth Caritas Next is new for 2027 and sells plans in 11 counties, including Columbus, Cleveland, Cincinnati, and Dayton.
- SummaCare is a regional option in four Northeast Ohio counties: Medina, Portage, Stark, and Summit.
Key cities
Columbus
Franklin County has seven marketplace insurers for 2027: Ambetter, AmeriHealth Caritas Next, Anthem, Antidote, Medical Mutual, Oscar, and UnitedHealthcare. Ohio State Wexner Medical Center is a major system. Check network coverage carefully since not all carriers include all hospitals.
Cleveland
Cuyahoga County has seven marketplace insurers for 2027 (eight companies, since both Oscar companies sell here). Cleveland Clinic and University Hospitals are the two dominant systems. If you have a preference for one, verify that your plan includes it.
Cincinnati
Hamilton County has seven marketplace insurers for 2027. UC Health, TriHealth, and Christ Hospital are key systems. CareSource, based in nearby Dayton, no longer sells marketplace plans, so former CareSource enrollees here need to compare the remaining options.
Dayton, Toledo, Akron
Mid-size Ohio metros have plenty of choice for 2027. Montgomery County (Dayton) and Lucas County (Toledo) each have seven insurers, and Summit County (Akron) has seven insurers including SummaCare. Network breadth varies more than in the three big metros.
Rural Ohio
Appalachian and rural counties in southeastern Ohio have fewer options, sometimes just two or three. Athens County has only Anthem and Medical Mutual for 2027, and Scioto County adds Ambetter. Premiums are higher, provider networks are thinner, and you may need to travel for specialist care.
Estimate your subsidy
Subsidy Estimator
Enter your info below to get a rough estimate of your monthly premium tax credit for a 2027 marketplace plan.
Resources
- HealthCare.gov for marketplace enrollment
- benefits.ohio.gov for Medicaid and other benefit applications
- Ohio Association of Free Clinics for free and low-cost care
- Community health centers: find one at findahealthcenter.hrsa.gov