Stable Coverage, Healthier Kids

Ohio’s Bold Move to Improve Early Childhood Health

In June 2023, Ohio made a smart, strategic decision to prioritize the health of its youngest residents. As part of the state’s biennial budget, House Bill 33 included a provision ensuring that children on Medicaid would receive continuous health coverage through their fourth birthday—an effort championed by Representative Andrea White (R-Kettering) and embraced with bipartisan support. Governor Mike DeWine signed the budget into law on July 4, 2023, and now, as Ohio Medicaid moves forward with implementation, this policy stands to reduce administrative headaches, minimize gaps in coverage, and most importantly, improve health outcomes for children in their earliest years.

We know how critical those first three years of life are. Research shows that stable access to healthcare in early childhood lays the foundation for a lifetime of better health, yet too often, families experience unnecessary interruptions in coverage. Income fluctuations, paperwork burdens, and eligibility reviews frequently lead to gaps that result in missed check-ups, delayed vaccinations, and postponed early interventions—setbacks that can have lasting consequences.

And the data backs this up.

According to Groundwork Ohio’s new Early Childhood Data Dashboard, only 17.6% of Medicaid-enrolled children ages 0-5 received a developmental screening in 2022.

visit www.groundworkohio.org/dashboard

That means the vast majority of young children in Ohio—who rely on Medicaid—are missing critical early screenings that could identify developmental delays and connect them to support services when they’re most effective. When kids lose coverage, those numbers only get worse. Continuous Medicaid eligibility helps prevent these gaps, ensuring children can access the care they need before small issues turn into bigger challenges.

Studies from the Georgetown Center for Children and Families reinforce that children with uninterrupted Medicaid access are significantly more likely to receive routine preventive care, reducing ER visits and avoiding costly hospitalizations. The Prenatal-to-Three Policy Impact Center highlights that children with stable Medicaid coverage are healthier, perform better in school, and are more likely to thrive as adults. Study after study illustrates the long-term economic benefits of policies like this, showing that investing in early healthcare leads to healthier children, stronger families, and a more prepared workforce.

Ohio’s decision to go beyond the federal requirement for 12 months of continuous Medicaid eligibility and extend it through age four is a big deal. It ensures that kids stay covered during the years when developmental screenings, well-child visits, and timely medical care are most crucial. It also saves families from the stress of frequent income verifications and helps the state reduce unnecessary administrative costs. Instead of forcing families to navigate a complicated system, Ohio is making it easier for them to do what really matters—keeping their children healthy.

What’s happening here also reflects a larger national conversation. Under the Consolidated Appropriations Act of 2023, all states must now provide at least one year of continuous coverage for children in Medicaid and CHIP. But Ohio is setting itself apart by going further recognizing that healthcare consistency during these early years is a necessity, not a luxury.

As the state finalizes the details, there’s an opportunity for public input. The Ohio Department of Medicaid has opened a public comment period on its Section 1115 waiver request, which is required for full implementation of this policy. Families, healthcare providers, and advocates can weigh in until April 2, 2025, to show their support and share why this matters.

Policies like this are a win for kids, a win for families, and a win for the long-term health of Ohio. By ensuring young children have the stability they need to access healthcare, we’re making an investment in their future—and in the future of our state.

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~ Shannon Jones, Founder & Strategist, On Key Strategies