Protect Medicaid: Safeguarding the Health of Ohio’s Mothers and Young Children

Groundwork Ohio
Apr 28
5 min read

By Caitlin Feldman, Policy Director

Follow Caitlin on LinkedIn.

Ohio’s Medicaid program is a lifeline for children, pregnant women, and families across the state. Covering nearly half of all births and almost 48% of children under age six, Medicaid ensures that Ohio’s youngest residents receive the health care they need to thrive. Yet, proposed state changes to Ohio’s Medicaid program, including the introduction of work requirements, removal of continuous eligibility for children 0-3, and the looming threat of coverage loss for the Medicaid expansion group and others depending on the choices made by Congress, threaten to undermine access to health care for many thousands of Ohio’s women and children. If enacted, these changes could lead to widespread coverage losses and worsening health outcomes for Ohio’s children and families.

The Important Role of Medicaid Coverage for Ohio Families

Early childhood is a period of rapid brain development, with more than one million neural connections forming every second. Health coverage during this time supports cognitive, social, and emotional growth, helping children enter kindergarten ready to learn while setting the stage for lifelong success. Medicaid provides:

Comprehensive Preventive Care – Including immunizations, developmental screenings, and dental and vision services to detect and address health concerns early.
Support for Children with Special Needs – Covering physical and occupational therapy, in-home nursing, and specialized medical equipment.
Mental Health Services – While the private insurance market may or may not reimburse for mental and behavioral health services, Medicaid ensures children and parents have coverage for behavioral and mental health services.

Read Caitlin Feldman’s House Bill 96 testimony to the Ohio House Medicaid Committee.

The Urgency of Medicaid Access for Pregnant and Postpartum Women

Ensuring that women are healthy before pregnancy is critical for positive birth outcomes. Women on Medicaid are more likely to have behavioral health conditions and chronic diseases that increase health risks during pregnancy. The Ohio Department of Medicaid recently reported that among pregnant women:

34% of pregnant moms had a mental health diagnosis
10% had a substance use disorder
28% had hypertension
18% had diabetes.

Managing health conditions before, during, and after pregnancy is essential to improving maternal and infant health outcomes. Recent efforts to implement work requirements risk disrupting access to necessary care. While pregnant women may be exempt from work requirements, no such protection is guaranteed postpartum—potentially forcing vulnerable new mothers into dangerous coverage gaps at a time when early intervention is vital.

In a recent report, the Ohio Departments of Health and Children and Youth found 66% of pregnancy-related deaths were deemed preventable during the reporting year. Delays in care, especially during pregnancy and postpartum periods, can have severe life-threatening consequences and work requirements add unnecessary barriers to coverage for these women.

Furthermore, child care is among the greatest expenses for a family with young children. Work requirements increase challenges for parents balancing employment with caregiving responsibilities. In a recent Groundwork Ohio poll, 49% of Ohio parents indicated they reduced work hours due to the lack of affordable child care, and 61% of non-full-time working mothers stated they would return to work if affordable, quality care were available. Without accessible child care, work requirements create a catch-22, where parents are expected to work but don’t have the resources to do so.

Groundwork Ohio submitted public comment to the Centers for Medicare and Medicaid Services regarding Ohio’s Group VIII 1115 Demonstration Waiver Application.

Sound of Ideas interview with Emily Campbell, President & CEO of the Center for Community Solutions, discussing the devastating impact of coverage loss for Ohio’s Medicaid Expansion Population.

Coverage Loss for Parents Impacts Children’s Health

Children whose parents are uninsured are more likely to be uninsured themselves. Multi-year continuous coverage for children ages 0-3 was a landmark win in 2023 when this provision was enacted into state law. This law ensures coverage loss does not occur due to administrative red tape while providing consistent access to well-child visits, immunizations, and early detection of health or developmental challenges.

Despite being a critical safeguard against coverage gaps for young children, multi-year continuous coverage for 0-3 year-olds was removed from Substitute House Bill 96 while the bill was in the Ohio House of Representatives. As the bill continues deliberations in the Senate, multi-year continuous coverage for infants and young children is at great risk for elimination before it has even fully gotten off the ground.

Groundwork Ohio submitted public comments to the Ohio Department of Medicaid in support of Continuous Eligibility for Children Birth through Age Three and again in support of the 1115 Demonstration Waiver Application for Continuous Eligibility.

Children’s Health Care Report Card: Ohio

Snapshot of the number of children in Ohio without insurance coverage.

Addressing Ohio’s Infant Mortality Crisis

Ohio’s infant mortality rate remains alarmingly high, particularly for Black infants, who experience mortality rates more than twice that of white infants. Medicaid coverage is a key tool in combating these disparities by ensuring access to prenatal and postpartum care, preventive services, early detection, and timely access to treatment. Doula support, provided by uniquely qualified individuals who offer advocacy, education, and individualized care for women during pregnancy, labor, and postpartum, can play a vital in reducing maternal and infant mortality, particularly among Black women who are most at risk of adverse birth outcomes.

As recently as October 2024, the Ohio Department of Medicaid began reimbursing doulas for their services, allowing greater access to doula support among vulnerable pregnant women. Unfortunately, just six months later, the Ohio House of Representatives has advanced a version of Substitute House Bill 96 wherein Medicaid reimbursement for doula services are limited to the six counties with the highest infant deaths.

Groundwork Ohio’s Caitlin Feldman speaks with Senator Hicks-Hudson and Senator Ingram during a Press Conference covering the inaugural Black Maternal Health Caucus Summit.

The Path Forward: Protecting Medicaid is Protecting Ohio’s Future

Medicaid is not just a safety net—it is the cornerstone of healthy childhood development, strong families, and a more prosperous Ohio. Research shows that investments in early childhood yield a 13% return on investment for every dollar spent, benefiting individuals and the broader economy alike.

Join Groundwork Ohio in urging state policymakers to:

RESTORE multi-year continuous Medicaid coverage for children ages 0-3.
RESTORE Medicaid reimbursement of doula services to all 88 Ohio counties.
PRESERVE and STRENGTHEN Medicaid coverage for parents and young children.

How Medicaid and Home Visiting programs support a continuum of health and well-being for moms and babies: Ohio House budget cuts ‘lifesaving’ free home visits from nurses for moms, newborns.

Get Involved: Use Your Voice to Protect Medicaid for Ohio’s Moms and Babies

Do you have a personal story about how Medicaid has helped you or your family? We are collecting stories from across the state to shed light on our question: “But for Medicaid…” how would your family’s health story be different? To participate in a brief interview and share your story, please contact Malissa Harris at mharris@groundworkohio.org.
View and share our new Medicaid fact sheet.