Ohio could lose more than 51,000 jobs and see its economy shrink by over $5 billion (£3.78 billion) by 2029 as federal cuts to healthcare and food assistance programmes begin to bite, according to a recent analysis by the Commonwealth Fund.
The report warns that reductions to Medicaid funding, combined with the expiration of enhanced Affordable Care Act (ACA) subsidies, will have significant economic consequences for the state. While federal support for rural healthcare is expected to provide some relief, researchers argue it will not be enough to offset the broader financial damage caused by the spending changes.
Healthcare Funding Reductions Expected to Weigh on Growth
The analysis projects that Ohio will lose approximately 51,200 jobs by 2029, making it one of the hardest-hit states in the country. The state is also expected to forfeit around $4.4 billion (£3.3 billion) in federal funding, leading to a reduction of roughly $5.4 billion (£4 billion) in gross domestic product and a decline in state and local tax revenues.
Republicans included a rural healthcare fund within the 2025 spending legislation, with Ohio expected to receive around $200 million (£151.3 million) from the programme. The funding was designed to address concerns that lower Medicaid spending could threaten the viability of rural hospitals and healthcare providers.
However, the Commonwealth Fund concluded that the benefits of the rural healthcare investment would be outweighed by much larger cuts elsewhere. Researchers pointed specifically to the loss of ACA marketplace subsidies that were introduced during the pandemic and later allowed to expire.
The end of those subsidies has already had a noticeable effect in Ohio. Many residents purchasing health insurance through ACA exchanges experienced steep premium increases, prompting some to switch to less comprehensive plans while others left the marketplace entirely. According to healthcare policy analysts, enrolment in Ohio's exchanges fell by around 20% this year.
Ohio will lose 51,200 jobs and $5.3 billion in GDP by 2029 from Medicaid and food assistance cuts in Trump's "Big Beautiful Bill" and the expiration of ACA subsidies, according to a Commonwealth Fund analysis. Read more: https://t.co/DQX7okIC0R pic.twitter.com/BTqAlU3orR
— TiffinOhio.net (@TiffinOhioNews) June 22, 2026
Safety Net Cuts Linked to Wider Economic Impact
The report argues that the most severe economic effects will emerge once the full provisions of President Donald Trump's spending legislation are implemented. The law includes more than $900 billion (£680.45 billion) in Medicaid reductions over a decade, alongside cuts of approximately $187 billion (£141.4 million) to the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps.
Researchers said the changes would not only affect individuals who rely on government assistance but would also reduce economic activity across entire states. Federal healthcare and food assistance spending supports hospitals, clinics, pharmacies, care providers and local businesses that depend on consumer spending.
Nationally, Medicaid funding is expected to fall by nearly $91 billion (£68.8 billion) in 2029. As a result, state economies could collectively lose more than $118 billion (£89.2 billion) in economic output, while close to one million jobs may disappear nationwide. Around half of those losses are expected to occur within the healthcare sector.
Work Requirements Could Create Additional Challenges
A key component of the legislation is the introduction of stricter work requirements for Medicaid recipients. It's a measure supporters argue will encourage employment and reduce dependence on government assistance.
The Commonwealth Fund disputes that claim, arguing that previous work requirement programmes have shown limited success in boosting workforce participation. Researchers contend that barriers such as poor health, caregiving responsibilities and limited employment opportunities are often the primary reasons people remain out of work.
The report further warns that shrinking local economies and reducing employment opportunities in lower-income communities could make it even harder for affected residents to secure jobs, potentially undermining the policy's stated objectives.
