State Budget feature image Former Gov. John Kasich signs the FY 2018-2019 biennial state budget.

State Budget

Every two years, the governor and Ohio General Assembly work to develop the budget for the state’s programs and various state agencies.

This deliberative process is an ideal opportunity to promote hospitals and health systems as policymakers evaluate and decide on how best to allocate state resources and policy for health care.

Ohio’s biennial state budget has far-reaching implications for both health care delivery and reimbursement in our state.

Executive Budget Quick Links

  • The DeWine Administration's FY 20-21 Executive Budget website:

  • Office of Budget and Management:

  • Legislative Service Commission Redbooks are posted to the website as they become available. Medicaid’s can be found here.

  • The Department of Medicaid’s whitepapers can be found here.

  • The document related to the hospital franchise fee proposal is available here.

Substitute Budget Bills

The Ohio House Finance Committee on May 2 proposed a substitute budget bill, Sub. HB 166.

The Ohio Senate Finance Committee on June 11 porposed its substitute budget bill, Sub. HB 166.

Here is the comparison document for the Senate bill.

Here is the appropriations spreadsheet for the Senate bill.

Here is a link to the amendments package for the Senate bill, passed on June 18.

Here is the link to the Senate-passed version of the bill passed on June 20.

Health Care and the State Budget

During state budget negotiations, there are many interest groups competing for financial resources. How these resources are allocated to fund health care programs, particularly Ohio Medicaid, is a top priority for OHA and many other advocacy groups representing patients and providers.

To achieve our goal of strengthening and healing Ohio communities, OHA will continue to advocate for state budget solutions that provide sufficient reimbursement for hospitals while protecting access to health care.

2020-2021 State Budget Priorities

OHA's Advocacy efforts for spring 2019 are focused on assuring the following hospital priorities are reflected in the biennial 2020-2021 state operating budget:

  • Maintaining Medicaid coverage
  • Reforming the hospital franchise fee methodology
  • Enhancing Medicaid managed care accountability
  • Maintaining financial stability and predictability for hospitals


The 2020-2021 state budget process began with state agencies submitting their budget requests to Ohio’s Office of Budget and Management in fall 2018. Taking into consideration these budget requests, Gov. Mike DeWine will propose the executive budget, which will be presented to the Ohio General Assembly on or around March 15, 2019.

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. The governor may exercise his veto power to disapprove of a specific item or items in the bill without vetoing the entire legislation. The line-item veto authority is limited to spending bills and only allows a governor to remove items from a bill, but not to add any items or language.

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 typically is enacted by July 1 of every odd-numbered year. For example, Ohio’s 2018-2019 biennial state budget was enacted June 30, 2017 and runs from July 1, 2017 through June 30, 2019.

State Budget Timeline Illustration