As a doctor, I'm telling you that Medicaid cuts will cost Ohio money — and lives

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2 days ago

As a Cincinnati doctor, I see what Medicaid cuts will cost us. I work as a primary care physician in Cincinnati − much of my job involves counseling people on the long-term risks of today's actions. I remind parents that juice contributes to early diabetes in their children. I teach teenagers that regular cannabis use increases the risk of psychosis. I urge patients to take their blood pressure medications to avoid future strokes and heart attacks. I refer people for colonoscopies to catch cancer early.
My job is about prevention − acting now to avoid suffering later. Congress is about to do the opposite.
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The House Budget Reconciliation Bill includes drastic cuts to Medicaid, which will take health insurance away from Ohioans. If passed, these cuts won't just cost the state billions of dollars − they'll cost lives. Estimates suggest that between 300,000 and 500,000 Ohioans will lose their health insurance coverage due to these cuts. They are unlikely to find other options.
Employment benefits won't suddenly appear. In 2018, the Ohio Department of Medicaid reported that the vast majority (93.8%) of Ohio Medicaid recipients were employed, in school, taking care of family members, or navigating severe illness. The average Ohioan on Medicaid won't be able to afford private health insurance − self-insured plans cost upwards of $8,000 per year.
The result? Fewer people will get the care they need. Uninsured individuals are three times more likely to postpone or avoid seeking care and much more likely to skip medications due to cost. People won't stop getting sick − they'll just stop getting care.
When care stops, hospitals close. According to a 2025 report from the Center for Healthcare Quality and Payment Reform, 'over the past two decades, nearly 200 rural hospitals have closed. As a result, the millions of Americans who live in those communities no longer have access to an emergency room, inpatient care, and many other hospital services that citizens in most of the rest of the country take for granted."
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As of April 2025, there are eight Ohio hospitals at risk of closing, and there are 34 Ohio hospitals operating at a financial loss. If these Medicaid cuts go through, hospitals in Ohio will have to provide more than $2 million more in uncompensated care each year, while missing out on millions in revenue from covered care. This financial stress will be too much. Hospitals will close, costing communities thousands of jobs and worsening health care shortages in areas.
Once hospitals close, patients will have to travel further and wait even longer. They will delay care due to these inconveniences, and they will suffer more. Eventually, they'll still seek care − because illness doesn't wait. But often, it will be too late.
A few years back, I took care of a patient in the hospital who was living with diabetes and hypertension. He lost his insurance when he lost his job during the COVID-19 layoffs. Without health insurance and transportation, he couldn't see a doctor. He ignored the worsening numbness in his feet and blurry vision while he desperately tried to stay housed and find work.
By the time he realized how sick he was and finally arrived at the hospital, his foot was gangrenous, the infection had spread to his bones, and he had suffered multiple small strokes. His eyesight was permanently damaged. After extensive surgeries and a prolonged hospital stay, he was discharged to a nursing facility, where he faced an uphill battle to recover.
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This story is not unique. Each year, millions experience lapses in their health care coverage, leading to delayed or forgone care. If these cuts to Medicaid pass, there will be millions more. Uninsured adults are more likely to delay care, to develop more serious illnesses with more complicated and longer hospital stays, and are at increased risk of early death.
The decisions lawmakers make today will have lasting effects. As a doctor, I see the human cost of delayed care and insurance lapses every day. As an Ohioan, I know our communities can't afford this.
Call your representatives and senators. Tell them to protect our health and our hospitals. Tell them: Don't cut Medicaid.
Joshua Smith is a resident physician at The Christ Hospital and University of Cincinnati Medical Center, training in Family Medicine and Psychiatry. All opinions and views expressed here are his own and do not reflect those of his places of work or employers. The information provided does not represent medical advice, and patient details have been changed to protect privacy.
This article originally appeared on Cincinnati Enquirer: Ohio will lose healthcare access if Congress cuts Medicaid | Opinion