Stacks and stacks of plastic storage bins fill the closets, cupboards and corners of Casey Daulbaugh's home in Bowling Green. She keeps them neat and orderly, tucked away out of sight, but their presence on her mind is heavy.
They're full of medications and medical supplies. The bins are packed to the brim with everything from lidocaine pain patches and knee braces to prescription Zofran to treat nausea and Gabapentin for seizures and pain.
Daulbaugh, 33, has Postural Orthostatic Tachycardia Syndrome, or POTS. With federal cuts to Medicaid expansion looming, she’s fearful she’ll lose coverage. So she’s been rationing her medications – keeping as many doses as possible on reserve in case of emergencies.
“You feel like you have to do this with everything that's going on,” she said. “It's kind of going between, do I feel like I'm being irrational? Am I being in survival mode? That's not rational. Am I hoarding? Am I panicking?”
The proposed federal budget from U.S. House Republicans would cut $880 billion from Medicaid over the next decade. Should the budget pass, and if the Ohio Senate declines changes to trigger language in the state budget, about 800,000 Ohio adults enrolled in Medicaid expansion, like Daulbaugh, could lose coverage.
Ohio's role in Medicaid
The federal government pays 90% of the costs for Ohio’s Medicaid expansion enrollees under the Federal Medicaid Assistance Percentage (FMAP), or the rate at which the federal government matches state spending on Medicaid.
Gov. Mike DeWine’s budget bill included a trigger clause that would “immediately discontinue all medical assistance” for Ohioans under Medicaid expansion if the federal government’s contribution were to fall below that 90%.
The Ohio House has made several changes to that trigger language, according to the Center for Community Solutions. That includes requiring the state to implement a phased transition plan if the FMAP falls below 90% during fiscal years 2026 and 2027. The plan would require assistance for individuals who lose Medicaid eligibility by facilitating their enrollment in private insurance premium subsidy programs or charity care initiatives.
The budget proposal does not mention how the transition plan would occur, according to the Center for Community Solutions.
The state budget bill currently sits with the Ohio Senate. Public testimony is scheduled for late May and a Senate vote is expected in mid-June.
Preparing for cuts
Though there are unknowns surrounding the future of Medicaid expansion in Ohio, Brandy K. Davis, a policy expert with the Center for Community Solutions, encouraged people to educate themselves on their Medicaid qualifications.
“It's important to not panic and to make a plan,” she said. “That's really, really important for people to know and be aware of their qualification status. Because if something happens, they'll be able to make an appeal, or know that they should make an appeal."
Davis said she’s most concerned for babies, children and people living in rural communities. Medicaid covers more than 40% of births in Ohio and more than 30% of children in rural areas. She also expressed concern for hospital emergency departments, which could become inundated with patients who forego primary and specialty care after losing Medicaid coverage.
That’s part of why some Republicans have pushed back on Trump’s plan to make cuts. But for now, the Trump administration has held firm, saying major cost cutting is needed for federal tax cuts.
Davis said it won’t be much longer until the picture becomes clearer and the federal and state budgetary process is complete. In the meantime, she suggested working with a doctor to prepare.
“You want to make sure that you express those concerns that you're having with your providers to see [if] you can do a 90-day prescription or something just to sort of stay on top of things,” she said.
She also noted that people on disability should maintain their Medicaid coverage under the proposed budget.
Daulbaugh said she’s cautiously optimistic, but continues to prepare for every possibility. After a previous lapse in her Medicaid coverage, she says it took months for approval due to bureaucratic miscommunication. That has her fearful of more clerical errors and delay.
“There's so many lapses and obstacles between the programs,” she said. “It's crazy and it creates so much more chaos.”