Ohio’s veterans could suffer from federal Medicaid cuts
Military veterans in Ohio could suffer from the cuts to Medicaid in the federal budget bill signed by President Donald Trump in July. A fading level of safety-net supports for veterans could have consequences when it comes to recruiting new service members, according to a former surgeon general for the U.S. Navy.
While active and former members of the military may have access to care through the U.S. Department of Veterans Affairs (VA), some may not know about it, and some may not be eligible for care in the same way they are eligible for Medicaid. For that reason, 1.7 million veterans rely on Medicaid in the U.S.
Dr. Forrest Faison, who led the medical and health care systems for the U.S. Navy as surgeon general until 2019, said the group of veterans who rely on Medicaid “tends to be these high-need, very vulnerable populations.”
Faison is now provost and senior vice president of academic affairs at Northeast Ohio Medical University.
Coverage through the VA depends on a “disability rating,” according to Faison, which is determined based on your years of service, service-related injuries and other factors. For some that are severely disabled after leaving the service, the VA provides full-service benefits. For others, less coverage is available.
The veteran Medicaid population, which amounts to about 10% of the entire veteran population, uses the program for mental health, housing and other services they may not be able to receive through the VA system.
“There are also veterans that don’t have a very high disability rating, but are nonetheless veterans, who may depend on Medicaid because of job issues, disability, PTSD, things like that,” Faison said.
Ohio will see a $33 billion decrease in federal Medicaid spending over the next ten years, part of the $911 billion in total Medicaid cuts across the country for the next decade, according to estimates from health policy research organization KFF.
The reductions come at a time when more members of the military than ever are coming back from conflict, which Faison called “high combat survival.”
“We’re routinely saving men and women who would have died in any previous conflict,” Faison said, meaning the support for these men and women’s health care should be improving, rather than being cut.
Where will the cuts come from?
One thing the federal budget bill didn’t do was reduce the federal match Ohio receives from its current 90%, meaning the state’s Medicaid expansion group is still in place. The state operating budget included language that would have eliminated the group if the federal match went down even 1%.
The estimated losses would come the implementation of work requirements in the federal bill, which imposes new requirements on those aged 19 to 64 who are in the Medicaid expansion population, with exemptions for things such as medical conditions or individuals with young children.
“Previous evidence suggests that work requirements may cause many Ohioans to lose their insurance, even if they are employed or have a condition that exempts them from new requirements,” the Health Policy Institute of Ohio said in an analysis of the federal budget bill. “While the exact impact of these requirements will differ depending on upcoming federal guidance and state decisions, existing analyses based on Ohio’s submitted work requirements waiver suggest that up to 200,000 Ohioans could lose coverage.”
Other losses could come from taxes on medical providers, which states like Ohio use to create revenue for their Medicaid programs. These can include Medicaid managed care plans, commercial health insurers, nursing homes and hospitals. The Health Policy Institute of Ohio said restrictions included in the federal bill “will result in significant Medicaid funding shortfalls for Ohio.”
The state’s Medicaid department itself saw a drop in funding from the state operating budget, amounting to $93.7 million in fiscal year 2026 and $650 million in 2027, when compared to the executive budget proposed by Gov. Mike DeWine.
“Unless the state finds new revenue sources, Ohio will need to cut billions of dollars of annual Medicaid spending in the coming years,” the institute’s analysis stated.
The institute said “primary ways” in which the department could lower spending would be in the areas of provider reimbursement rates, covered services or eligibility groups, including Medicaid expansion.
Ohio veterans on Medicaid
It’s hard to tell how many veterans this might impact specifically, because while the application for Medicaid includes a box to note one’s veteran status, checking the box is optional, according to a spokesperson for the Ohio Department of Medicaid. The think tank Policy Matters Ohio noted that from 2021 to 2023, 1 in 10 Ohio veterans were enrolled in Medicaid and/or had a family member in the Children’s Health Insurance Program (CHIP).
Policy Matters Ohio researcher Heather Smith said in an August brief that the federal budget bill would not only cut Medicaid funding for veterans, but also implement workforce reductions at the U.S. Department of Veterans Affairs locations.
“Medicaid is crucial to filling health coverage gaps for many veterans, especially those who have low income or are unable to prove service-connected disabilities,” Smith wrote, adding that nearly half of veterans covered by Medicaid have reported a disability.
The U.S. Department of Veterans Affairs said in July that it was “on pace to reduce total VA staff by nearly 30,000 employees by the end of fiscal year 2025,” which the agency said would eliminate the need for a “large-scale reduction-in-force.”
The department had been considering reducing staff levels by 15%, but said through the federal hiring freeze, “deferred resignations,” retirements and “normal attrition,” the department wouldn’t go through with that plan.
“VA has multiple safeguards in place to ensure these staff reductions do not impact veteran care or benefits,” the department release stated, announced after Trump signed the budget bill.
The release also noted the “phasing out” of gender affirming care and ending of diversity, equity and inclusion practices at the department as proof that the VA “performance continues to improve.”
With reductions in both the VA and Medicaid, veterans on Medicaid expansion may see “more red tape” with increases to the number of times they must prove eligibility.
This redetermination process would occur twice a year instead of once per year, leading to an increase in administrative load along with extra work for those eligible for coverage. According to the Center on Budget and Policy Priorities, previous experience has shown that “people who still meet eligibility criteria will lose coverage and ‘churn’ on and off Medicaid, leading to interruptions in people’s medications and treatments.”
‘We have no plan’
The struggles that veterans may face in getting proper medical care and other services after they’ve come home from service reflects back to a country of young people who are debating service themselves, and the parents who want to make sure they remain as safe as possible.
“What we found and continue to find … is our recruiting and our ability to retain the force necessary to defend and protect us … depends on how well it’s perceived by others that we take care of our active duty and then from that, our veterans,” Faison said.
In his days as surgeon general of the Navy, Faison frequently asked leaders about a national strategy to help veterans, wounded or not, and how the country would support the future of the military through its care for those in uniform. He asked as military members came back from Iraq and Afghanistan, and as cuts to parts of the military care system kept coming in order to pay for other needs within the government.
“I asked these questions all four years I was surgeon general, and no one could answer those questions,” Faison said. “Which told me we have no plan.”
The Ohio Department of Veterans Services endeavors to get those who are eligible for VA services transitioned from Medicaid to VA care. The program “supports veterans with service-connected disabilities who are in long-term care,” according to the state Department of Veterans Services.
Since 2013, the Veterans On Medicaid program has “helped more than 75 veterans secure VA benefits and transition from Medicaid, allowing them to retain their VA pension or compensation while receiving comprehensive VA health care,” according to a spokesperson for the department.
The voluntary Veterans On Medicaid program is free for veterans, with outreach staff who help find placement at VA locations or other proper facilities.
Ohio has five VA medical facilities, located in Cleveland, Columbus, Chillicothe, Cincinnati and Dayton. The locations can mean struggles for veterans who are rural residents, which isn’t a small amount, according to Faison.
“A lot of these veterans, especially in Ohio, live in rural areas, where even if you’ve got some benefits, you may not have the services available,” he said.
Medicaid “was seen as a safety net” for those Faison knew who couldn’t readily access or didn’t know about their eligibility for VA coverage.
So as the federal government looks to make cuts to that safety net, the consequences have to be considered, he said. Those consequences aren’t only in quality medical care, but also in housing, food security and employment for veterans after their service. Consequences that could mean less interest in serving for fear of a lack of support afterward.
“Every mom and dad in America is looking at how well we take care of these folks to help influence whether their son or daughter puts on the uniform and serves our nation to protect us,” Faison said. “So there’s a lot riding on that.”
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