The economy is the top issue for Ohioans in a national poll released last month, with healthcare listed as a concern by 11% of respondents. The leading candidates for Ohio governor are being asked about health care affordability. And Dr. Amy Acton and Vivek Ramaswamy agree, at least in part, on work requirements for Medicaid, but have been blasting each other over other comments.
Work requirements for Medicaid recipients were passed by Republicans last year as part of what's become known as the One Big Beautiful Bill that President Trump signed last July. It requires recipients between 19-64 complete 80 hours per month of work, job or educational training, community service or a combination of those. There are exceptions for caregivers, pregnant women, disabled veterans and people who are medically frail, among others. Ohio was already pursuing a waiver to allow for work requirements, but the federal law supersedes that and orders compliance with work requirements by Jan. 1, 2027.
Acton, a former Ohio Department of Health director, said at a press conference Tuesday that "we need to have the requirements and easy ways to do it," and pointed to workforce training. But she said most Ohioans on Medicaid are already working, and noted in an interview the program is heavily relied on.
“Four out of ten births are on Medicaid. Three out of eight children receive their health insurance through Medicaid," Acton said. "And with the pressures we have seen with this administration cutting Medicaid, cutting health insurance coverage, we are seeing more and more Ohioans going without coverage."
And she added some people can't meet work requirements, so it's important to make health insurance available for them. If it's not, “all of us pay more in our health insurance. Our hospitals are under more duress when people are uninsured.”
Acton said 11 Ohio hospitals are in danger of closing, which she blames on Republicans in Congress. Acton said lack of affordable healthcare has hurt rural providers.
“I keep hearing stories from Ohioans that they have to travel in many parts of the state now an hour to an hour and fifteen minutes to deliver a baby or to have their kid's cavity filled. I’m actually hearing stories that babies are being born roadside again," Acton said.
Acton said eliminating subsidies for the Affordable Care Act has also left some Ohioans without the ability to provide healthcare for their families or employees. She said making health care services and drugs more affordable would help bring down the costs and increase the quality of health for all Ohioans.
Republican Ramaswamy responds
Like nearly all Republicans, Vivek Ramaswamy has been a supporter of work requirements for Medicaid recipients. But his campaign said in a written statement he supports the program.
“Medicaid is a vital program that millions of Ohioans rely on, and it must work better for the people it serves and for taxpayers who fund it," the statement reads. "Vivek believes Ohioans deserve a Medicaid system that delivers stronger results than what we have seen over the past six decades, including basic work requirements for those who are able.”
Ramaswamy said in an interview with Ideastream's The Sound of Ideas in December that he wants "thoughtful health care reform", saying health care is too unaffordable and the outcomes aren't good compared to the money being spent.
"We need to bring down those health care bills. And I think one of the ways to do it is to think about how we actually put money in the pockets of Ohioans" by becoming a zero-income tax state, offering property tax relief, bringing down electric bills and housing costs, Ramaswamy said.
Acton and other Democrats have called out Ramaswamy for comments he made on the Ezra Klein podcast in October 2024, before he entered the campaign for governor. In that conversation, when asked whether Medicaid and Medicare were mistakes, Ramaswamy said, "I believe they were, with the benefit of retrospect, particularly with Medicaid, particularly the welfare state, without work requirements required attached to it."
Ramaswamy's campaign said the "attacks from Amy Acton, based on a cherry-picked 30 seconds from an 80-minute interview, are blatantly dishonest, but sadly typical of politics practiced by a government insider who is desperate to preserve the status quo."
In an updated statement Tuesday, Connie Luck with Ramaswamy’s campaign said Acton’s “far-left approach” to health care would drive up costs. Luck said Ramaswamy is focused on reforms to deliver lower costs and bigger paychecks for Ohioans, "not empty promises and government takeovers."
