¶ Overview
Vivek Ramaswamy’s gubernatorial campaign claimed “Medicaid reforms” and work requirements, like the work requirements in Trump’s “One Big Beautiful Bill,” were “not extreme but common sense.” Ramaswamy called Medicaid a “mistake” and called for an end to “permanent welfare,” as Trump’s “One Big Beautiful Bill” was projected to strip more than 254,000 Medicaid recipients in Ohio of their health insurance by 2034.
During his presidential campaign, Ramaswamy scrutinized Trump for not repealing and replacing the Affordable Care Act during the first Trump administration. In 2026, more than 469,000 Ohioans relied on Affordable Care Act marketplace plans for their health care.
¶ Vivek Ramaswamy Supported Medicaid Work Requirements That Would Strip Health Insurance Away From Ohioans, Like Trump’s “One Big Beautiful Bill”
¶ Vivek Ramaswamy Supported Work Requirements For Medicaid Recipients Like Trump’s “One Big Beautiful Bill”
2026: Ramaswamy’s Campaign Said The “Medicaid Reforms” And Work Requirements, Like The Work Requirements In Trump’s “One Big Beautiful Bill,” Were “Not Extreme But Common Sense.” According to the Columbus Dispatch, “President Donald Trump's ‘One Big Beautiful Bill’ will require many adults receiving Medicaid to document 80 hours of work, job training or community service per month. States must enforce the new requirement, which has exceptions for pregnancy, disability and other circumstances, by Jan. 1, 2027. Opponents of the new requirement say they create unnecessary hurdles for Medicaid recipients, most of whom are already working. […] Luck, Ramaswamy's spokesperson, said Medicaid reforms, such as work requirements, are not extreme but common sense.” [Columbus Dispatch, 2/10/26]
¶ Ramaswamy Proposed Implementing Work Requirements On Medicaid Recipients And Said Medicaid Was A “Mistake,” In Particular “Without Work Requirements Required Attached To It”
2025: Ramaswamy Proposed Implementing Work Requirements On Medicaid Recipients, Calling For An End To “Permanent Welfare.” According to Ramaswamy’s Twitter, “Ohio’s workforce participation has declined from nearly 70% at the turn of the century to 62% today, almost 2/3 of able-bodied Medicaid recipients don’t work or seek work, employers in our state struggle to fill open jobs, and the mental health epidemic worsens as a result too. It’s time to transition from permanent welfare to common-sense work requirements. That’s true compassion, the alternative is cruelty.”
[Twitter, @VivekGRamaswamy, 11/20/25]
October 2024: Ramaswamy Said Medicaid Was A “Mistake,” In Particular “Without Work Requirements Required Attached To It.” According to the Statehouse News Bureau, “Acton and other Democrats have called out Ramaswamy for comments he made on the Ezra Klein podcast in October 2024, before he entered the campaign for governor. In that conversation, when asked whether Medicaid and Medicare were mistakes, Ramaswamy said, ‘I believe they were, with the benefit of retrospect, particularly with Medicaid, particularly the welfare state, without work requirements required attached to it.’” [Statehouse News Bureau, 2/10/26]
¶ The “One Big Beautiful Bill” Was Expected To Strip 17 Million Americans Of Their Health Care, Including Nearly 254,000 Medicaid Recipients And 205,100 ACA Enrollees In Ohio
¶ The Congressional Budget Office Estimated That 11.8 Million Americans Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill
HEADLINE: "At Least 17 Million Americans Would Lose Insurance Under Trump Plan" [Washington Post, 7/1/25]
HEADLINE: “By The Numbers: Harmful Republican Megabill Favors The Wealthy And Leaves Millions Of Working Families Behind” [Center On Budget And Policy Priorities, 8/1/25]
HEADLINE: "House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy" [Center On Budget And Policy Priorities, 2/21/25]
Trump’s “One Big Beautiful Bill” Imposed Medicaid Work Requirements, Requiring States To Condition Medicaid Eligibility On Meeting Work Requirements. According to KFF, “On July 4, President Trump signed into law a budget reconciliation package once called the ‘One Big, Beautiful Bill’ that includes significant changes to the Medicaid program. The Congressional Budget Office (CBO) estimates the Medicaid work requirement provisions in the passed budget reconciliation law will be the largest source of Medicaid savings, reducing federal spending by $326 billion over ten years and cause millions to become uninsured. […] The law will require states to condition Medicaid eligibility for adults in the Affordable Care Act (ACA) Medicaid expansion group at application and following enrollment on meeting work requirements starting January 1, 2027, with the option for states to implement requirements earlier. Currently, 41 states (including DC) have expanded their Medicaid programs under the ACA to nearly all adults up to 138% FPL ($21,597 for an individual in 2025).” [KFF, 7/30/25]
The Congressional Budget Office Estimated That 11.8 Million People Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill. According to the Washington Post, "The bill, which narrowly passed the Senate on Tuesday and now heads back to the House, would effectively accomplish what Republicans have long failed to do: unwind many of the key components of the ACA, President Barack Obama’s signature domestic achievement, which dramatically increased the number of Americans with access to health insurance. To start, the Congressional Budget Office estimated that the Senate version of the bill would result in 11.8 million more uninsured in 2034, mostly because of Medicaid cuts, compared with 10.9 million if the House version became law." [Washington Post, 7/1/25]
¶ Nearly 459,000 Ohioans Were Expected To Lose Health Care Coverage Under Trump’s “One Big Beautiful Bill,” Including Nearly 254,000 Medicaid Recipients
Under The “One Big Beautiful Bill,” 458,969 Ohioans Were Expected To Lose Their Health Care By 2034, Including 205,100 ACA Enrollees And 253,869 Medicaid Recipients. According to the Joint Economic Committee Minority,
|
District |
State |
Est. # Losing ACA Coverage |
Est. # Losing Medicaid Coverage |
Est. Total # Losing Insurance |
|
OH-01 |
Ohio |
15,900 |
14,047 |
29,947 |
|
OH-02 |
Ohio |
12,500 |
19,274 |
31,774 |
|
OH-03 |
Ohio |
16,800 |
17,338 |
34,138 |
|
OH-04 |
Ohio |
12,500 |
14,698 |
27,198 |
|
OH-05 |
Ohio |
12,500 |
13,444 |
25,944 |
|
OH-06 |
Ohio |
11,600 |
18,762 |
30,362 |
|
OH-07 |
Ohio |
10,800 |
11,430 |
22,230 |
|
OH-08 |
Ohio |
13,800 |
15,660 |
29,460 |
|
OH-09 |
Ohio |
13,800 |
18,198 |
31,998 |
|
OH-10 |
Ohio |
14,600 |
17,987 |
32,587 |
|
OH-11 |
Ohio |
17,700 |
25,505 |
43,205 |
|
OH-12 |
Ohio |
11,600 |
16,454 |
28,054 |
|
OH-13 |
Ohio |
13,800 |
17,749 |
31,549 |
|
OH-14 |
Ohio |
12,100 |
15,579 |
27,679 |
|
OH-15 |
Ohio |
15,100 |
17,744 |
32,844 |
|
All |
Total |
205,100 |
253,869 |
458,969 |
[Joint Economic Committee Minority, 6/25]
- The House GOP Budget Bill Was Estimated To Increase The Uninsured Population By 8.6 Million By 2034. According to CNN, “The Medicaid and Affordable Care Act provisions in the package could result in 8.6 million more people being uninsured in 2034, according to an early CBO estimate released by Democratic lawmakers. That number is expected to grow with the latest changes.” [CNN, 5/28/25]
- The House GOP Budget Bill Codified A Trump Administration Proposal That Restricted Access To The Affordable Care Act. According to CNN, “The bill also calls for codifying a Trump administration proposal that would make changes to the Affordable Care Act enrollment process, including shortening the open enrollment period and eliminating the ability of low-income Americans to sign up year-round.” [CNN, 5/28/25]
¶ Vivek Ramaswamy Supported Repealing The Affordable Care Act, Even Though More Than 469,000 Ohioans Relied On ACA Plans For Their Health Care
¶ Vivek Ramaswamy Supported Repealing The Affordable Care Act
¶ Ramaswamy Scrutinized Trump For Not Repealing And Replacing The Affordable Care Act During The First Trump Administration
HEADLINE: “Vivek Ramaswamy Accuses Trump Of Making A 'False Promise' In Not Repealing Obamacare” [Associated Press, 9/21/23]
2023: Ramaswamy Scrutinized Trump For Not Repealing And Replacing The Affordable Care Act During The First Trump Administration. According to the Associated Press, “Republican presidential hopeful Vivek Ramaswamy swiped at former President Donald Trump on Thursday for failing to repeal and replace the health care overhaul championed by his predecessor, former President Barack Obama. ‘I am never somebody who will make a false promise,’ Ramaswamy said at an event in a suburb of Columbus, Ohio. ‘My friend Donald Trump promised us: repeal and replace Obamacare. Eight years later, did it happen? No, it did not. It is a false promise if it is contingent on Congress.’” [Associated Press, 9/21/23]
¶ 2026: 469,616 Ohioans Were Enrolled In An Affordable Care Act Marketplace Plan
2026, There Were 469,616 Individuals Enrolled In An Affordable Care Act Marketplace Plan In Ohio. According to KFF, in 2026, there were 469,616 individuals enrolled in Affordable Care Act marketplace plan in Ohio.
[KFF, Accessed 4/14/26]
¶ The Affordable Care Act Allowed States To Expand Medicaid, Which Dramatically Lowered The Uninsured Rate Among Low-Income Workers
The Affordable Care Act Allowed States To Expand Medicaid, And States That Expanded Medicaid Dramatically Lowered The Number Of People Without Health Insurance. According to the Center on Budget and Policy Priorities, "The Affordable Care Act (ACA) permits states to expand Medicaid coverage to adults with incomes up to 138 percent of the poverty level (about $20,780 annually for an individual or $35,630 for a family of three). States that have adopted the expansion have dramatically lowered their uninsured rates. Extensive research finds that the people who gained coverage have grown healthier and more financially secure, while long-standing racial inequities in health outcomes, coverage, and access to care have shrunk." [Center On Budget And Policy Priorities, 6/14/24]
- The Uninsured Rate Among Low-Income Workers Fell From 38 Percent In 2013 To 17 Percent In 2022, Which Coincided With Implementation Of Medicaid Expansion. According to the Center on Budget and Policy Priorities, "Millions of workers have gained coverage through Medicaid expansion, including people working in industries that provide critical goods and services such as health care, transportation, grocery stores, food manufacturers, and child care. Many have no access to health coverage through their jobs. In expansion states, the uninsured rate among low-income workers fell from 38 percent in 2013 to 17 percent in 2022; this sharp decline coincided with a large increase in the share of low-income workers enrolled in Medicaid.[16] In non-expansion states, the uninsured rate among low-income workers fell much less, from 46 percent to 31 percent. (See Figure 3.)" [Center On Budget And Policy Priorities, 6/14/24]