A new analysis from the Commonwealth Fund estimates that Ohio could lose approximately 51,200 jobs and more than $5 billion in economic activity by 2029 as a result of federal policy changes enacted under President Donald Trump's 2025 spending law.

According to the report, the economic impact stems primarily from major reductions in Medicaid funding, cuts to the Supplemental Nutrition Assistance Program (SNAP), and the expiration of enhanced Affordable Care Act (ACA) marketplace subsidies.

The analysis argues that these measures will reduce federal spending flowing into state economies, affecting healthcare providers, local businesses, and public revenues.The report states that Ohio will lose about $4.4 billion in federal funding, resulting in an estimated $5.4 billion decline in state gross domestic product and roughly $368 million less in state and local tax revenue.

Researchers also project significant employment losses, particularly in healthcare-related sectors such as hospitals, clinics, pharmacies, and nursing homes.Ohio is expected to rank among the states with the largest job losses nationwide.

The analysis notes that a rural healthcare fund included in the legislation would provide Ohio with approximately $200 million, but concludes that this amount would offset only a small portion of the broader funding reductions.It also highlights the expiration of ACA subsidies, which reportedly led to higher insurance premiums and lower marketplace enrollment in Ohio.Additionally, the report questions whether stricter Medicaid work requirements will achieve their stated goal of increasing employment.

Researchers argue that evidence from previous programs suggests such requirements have limited effects on workforce participation and could potentially make it harder for some residents to find jobs if economic activity declines in low-income communities.