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Balancing Ohio’s Budget: Declining Revenues, Greater Oversight of Medicaid
Ohio's Biennial State Budget
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    Ohio’s Biennial State Budget: Overview

    The state of Ohio operates on a biennial budget, meaning budgeting for the state’s programs and various state agencies normally runs on a two-year cycle. The state’s main operating appropriations bill, referred to here as Ohio’s biennial state budget, is typically enacted by July 1 of every odd-numbered year. For example, Ohio’s 2018-2019 biennial state budget was enacted on June 30, 2017 and runs from July 1, 2017 through June 30, 2019.

    The budget process begins with state agencies submitting their budget requests to Ohio’s Office of Budget and Management. Taking into consideration state agencies’ budget requests, the Governor proposes the executive budget, which is presented to the Ohio General Assembly. Following the legislative process, the Ohio General Assembly passes Ohio’s biennial state budget and the bill heads back to the Governor for final approval. Unlike the federal budget, Ohio’s Constitution requires the state to have a balanced budget. This prevents the state from deficit spending.

    Ohio’s Biennial State Budget: Healthcare

    During budget negotiations, there are many competing interests advocating for passage of a state budget that best represents their interests. How the state’s financial resources are allocated to fund healthcare programs, particularly Ohio Medicaid, is a top priority of many advocacy groups representing both consumers, providers, and others. Given that Ohio’s Medicaid program accounts for roughly half of the state’s budget, a significant portion of Ohio’s biennial state budget conversations center around this safety-net program.

    Position Statement

    Ohio’s biennial state budget has far-reaching implications for both healthcare delivery and reimbursement in our state. The Center for Health Affairs will continue its efforts to advocate for state budget solutions that provide sufficient reimbursement for hospitals while protecting access to healthcare for vulnerable populations.

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