Frequently asked questions about health insurance
coverage options in Ohio
Ohio has a federally facilitated exchange, which means residents in Ohio use HealthCare.gov to enroll in exchange plans. But Ohio is one of seven states that participates in plan management and the qualified health plan (QHP) certification process.
The exchange (marketplace) is an enrollment platform for individual and family health plans. These plans are used by a wide range of people, including early retirees who aren’t yet eligible for Medicare, the self-employed, and people employed by small businesses that don’t offer health benefits.
Read our overview of the Ohio health insurance marketplace – including news updates and exchange history.
The open enrollment period for individual/family health insurance in Ohio runs from November 1 to January 15. Enrollments completed by December 15 have coverage effective January 1, while enrollments completed in the final month of the enrollment window have coverage effective February 1.
Outside of open enrollment, you’ll generally need a qualifying event to be able to enroll or make a change to your plan. But for people who are eligible for premium tax credits and whose household income isn’t more than 150% of the poverty level, there’s an ongoing enrollment opportunity throughout 2022.
Learn more about enrollment opportunities in our comprehensive guides:
The ten insurers offering plans in Ohio’s exchange for 2022 include:
- AultCare
- Ambetter (Buckeye Community Health Plan)
- CareSource (CareSource’s service area expanded in 2020 to include 65 counties)
- Community Insurance Company (Anthem BCBS) (rejoined the exchange as of 29, after exiting at the end of 2017)
- Medical Health Insuring Corp. of Ohio (Medical Mutual)
- Molina (expanded service area to a total of 40 counties in 2021)
- Oscar Buckeye State Insurance Corporation (available in the Columbus metro areas)
- Oscar Insurance Corporation of Ohio (available in the Cleveland metro area)
- Paramount
- Summa
Some insurers expanded their coverage areas for 2022, resulting in all but two counties having at least three participating insurers; 20 counties have six or more insurers offering plans for 2022 (in 2021, there were 10 counties that had just two participating insurers, and in 2020, there were 29).
During the open enrollment for 2022 coverage, 259,999 Ohioans enrolled in individual market plans through the state’s exchange. That was by far a record high, and 29% higher than the year before, when only about 201,000 people enrolled.
In most states that use HealthCare.gov, including Ohio, enrollment initially peaked in 2016 and declined for the next few years, due in part to rate increases, the expansion of short-term plans, and the elimination of the individual mandate penalty at the end of 2018. But in Ohio and nationwide, there was an overall increase in enrollment for 2021, and enrollment grew to a record high in 2022.
The spike in enrollment in 2022 was due in large part to the American Rescue Plan’s enhancements to the ACA’s premium subsidies. Under the ARP, subsidies are larger and more widely available, through the end of 2022 (they could be extended past that, but only if Congress takes action to do so).
Ohio’s U.S. Senators are split on healthcare reform. Sherrod Brown, a Democrat, supports the ACA, while Rob Portman, a Republican, is a vocal opponent of the ACA.
In the House, Ohio’s delegates now include 12 Republicans and just four Democrats. Only one of those Republicans – David Joyce, who won re-election in 2018 – voted against the GOP’s American Health Care Act, which was an effort to repeal the ACA.
Ohio’s state legislature has a strong Republican majority, and former Governor John Kasich, also a Republican, was not a fan of the ACA in general. (He didn’t see it as being effective in reducing healthcare costs and claimed it was “messing up the economy.”) So it’s no surprise that Ohio opted for a federally facilitated exchange rather than running its own exchange.
But Kasich broke ranks with most of his fellow Republican governors – and with his state’s legislature – in opting to expand Medicaid in Ohio. His reasoning was that it would have been immoral to not do so, and he’s vehemently challenged Republicans on this issue. Ohio’s average monthly Medicaid enrollment has grown by more than a million people since 2013, which is a 50% increase.
Kasich was also vocal in his opposition to Congressional Republicans’ proposals to fully repeal the ACA, including Medicaid expansion. Kasich met with President Trump and then-HHS Secretary Tom Price in 2017 to address his concerns and discuss possible reforms to the current system.
Kasich was term-limited and could not seek re-election in 2018. Republican Mike DeWine won the governor’s race, and took office in January 2019. DeWine has long opposed the ACA, but his position on Medicaid expansion appeared to soften as of 2018, when he said that the state would keep Medicaid expansion in place if he became governor. DeWine has served as the state’s attorney general since 2011. And while he joined in a lawsuit that year that challenged the constitutionality of the ACA, he did not join in the Texas v. Azar case (later called California v. Texas), in which 18 GOP-led states sought to overturn the ACA. The Supreme Court upheld the ACA in that case, in a 6-3 ruling issued in the the summer of 2021.
Ohio’s acceptance of federal funding to expand Medicaid eligibility to 138% of poverty has played a significant role in the state’s success with Obamacare.
Between 2013 and early 2022, the state saw an increase of more than a million people covered by Medicaid and CHIP, growing the state’s total Medicaid/CHIP population by 50%.
The increase is due to a combination of Medicaid expansion (which covers more than 831,000 people as of fiscal year 2022) and the COVID pandemic. The pandemic resulted in job losses that made people newly eligible for Medicaid, and the Families First Coronavirus Response Act has ensured that nobody is disenrolled from Medicaid during the COVID public health emergency (eligibility redeterminations have been paused since March 2020).
Read more about Medicaid expansion in Ohio.
The Trump administration relaxed the federal rules for short-term plans in 2018, allowing them to have much longer durations, including extensive renewals. But the new rules are clear in noting that states can impose stricter guidelines. Ohio allows short-term health insurance plans to have terms of up to 364 days, but renewals are prohibited. However, after a short-term policy ends, the policyholder can apply for a new policy.
Read more about short-term health plans in Ohio.
As of January 2021, there were 2,383,652 Ohio residents enrolled in Medicare. Most are eligible for Medicare due to age, but about 16% are under the age of 65 and eligible for Medicare due to a disability.
You can read more about Medicare in Ohio, including details about optional Medicare Advantage and Part D prescription plans, as well as the specifics about Ohio’s rules for Medigap policies.
