Ohio Gov. Mike DeWine officially requests federal approval for Medicaid work requirements

By Megan Henry / March 4, 2025

Ohio Gov. Mike DeWine has officially asked the Centers for Medicare and Medicaid Services to approve Medicaid work requirements. 

Under the proposal, Ohio Medicaid expansion recipients would need to be at least 55 years old, employed, be enrolled in school or a job training program, be in a recovery program, or have a serious physical or mental health illness.

“As part of our work to empower people to reach their full potential, we have a responsibility to make sure as many Ohioans as possible are on a pathway toward financial independence,” DeWine said in a statement. “Reinstating our work requirement will promote self-sufficiency, it will give more people the purpose and pride that comes with a job, and it will improve the well-being of Ohio’s workforce.” 

Medicaid offers health coverage to households making at or below 138% of the poverty line — $44,367 a year for a family of four. About 92% of U.S. adults under age 65 and eligible for Medicaid are already working or are exempt from requirements due to caregiving responsibilities, illness or disability, or school attendance, according to the Kaiser Family Foundation.

Hundreds of Ohioans submitted comments to the Ohio Department of Medicaid opposing the requirements, and Ohio medical professionals argued that extensive research has shown that work requirements won’t increase employment but they do limit access to care to people who need it.

DeWine sent a letter to Health and Human Services Secretary Robert F. Kennedy, Jr. asking to approve the work requirements on Friday. Ohio House Speaker Matt Huffman and Ohio Senate President Rob McColley also signed the letter. 

The Centers for Medicare and Medicaid will now review Ohio’s waiver and then the federal agency will have a 30-day comment period, said Ohio Department of Medicaid Spokesperson Stephanie O’Grady. 

Once those steps are completed, Ohio’s Medicaid department will begin talks with the federal agency about setting up state terms and conditions, O’Grady said. 

“We are dedicated to delivering high-quality healthcare to millions of Ohioans every day, empowering them to take control of their own health,” ODM Director Maureen Corcoran said in a statement. “By encouraging them to seek employment, we not only enhance their quality of life, but also contribute to healthier communities and a thriving economy in Ohio.” 

The proposed Medicaid work requirements mean more than 61,000 Ohioans could lose their health insurance according to estimates from ODM. The two goals of the requirement are “promoting economic stability and financial independence; and improve health outcomes by encouraging individuals to be engaged with their health and healthcare,” according to ODM. 

Ohio’s 2023 budget requires the state Medicaid department to re-apply with the federal government under the new presidential administration for permission to impose work, drug testing, and/or education requirements for adult Medicaid health coverage recipients. 

ODM received more than 450 comments on the proposed Medicaid work requirements and an overwhelming majority opposed the requirements with many sharing about their personal experiences with Medicaid.