HOW OHIO IS SHIFTING THE COST OF SPECIAL NEEDS CARE UNTO OVERBURDENED PUBLIC SCHOOLS

5-29-2026
THE SILENT PURGE
COLUMBUS, OH — A quiet crisis is unfolding across Ohio, hidden behind spreadsheets of state budget cuts and "program integrity" initiatives. Hundreds of thousands of Ohioans are being systematically pushed off the Medicaid rolls—but the most devastating, unexamined casualties of this purge are children with complex, high-support developmental and physical disabilities.
Under the guise of streamlining services, the state has actively squeezed children off individualized community-based waivers and Medicaid coverage, effectively transferring the legal and financial responsibility of their medically necessary care to local public school districts. Through the newly implemented "School Services Plan of Care" system, schools are being told to step in where state health infrastructure stepped out.
The reality on the ground is a disaster for families. Public schools—already battling historic staffing shortages, underfunded special education programs, and overstretched resource rooms—cannot act as comprehensive medical providers. They cannot replicate the line-of-sight supervision, intensive behavioral interventions, or specialized private therapies that keep these children stable.
When the state purges a special needs child from Medicaid, they aren't fixing a budget; they are abandoning a family. They are pushing highly vulnerable children into classrooms where the help they were promised legally simply does not exist.
We are demanding that the Ohio Department of Medicaid and the Department of Education release the full, unredacted data showing exactly how many children with active IEPs have been dropped from health coverage since these budget cuts took effect. The state cannot use administrative friction to hide the human cost of its fiscal policy. Ohio’s children are not line-item casualties.