MetroHealth will lead a community-wide push to get more residents signed up for health insurance this fall, as it braces for federal Medicaid cuts and potential funding reductions from Cuyahoga County.
The county hospital, known as a safety net hospital, says it doles out more than $1 million each day in charity care, an unsustainable level. Charity care is health care the hospital provides to residents for free or at a reduced cost. MetroHealth receives county tax dollars to pay for it, but that only covers about 10% of the unpaid care provided each year, the hospital said.
Charity care mostly covers patients who are ‘underinsured’ – often meaning an insurance plan that requires high out-of-pocket costs – or who don’t have insurance at all. The number of uninsured people MetroHealth saw monthly rose between early 2023 and late 2024. Without insurance, the hospital is less likely to be paid for the health care it provides.
Now, MetroHealth says it’s partnering with local organizations, faith communities and neighborhood groups to reach uninsured residents and guide them through the insurance enrollment process.
It plans to hold three Health and Enrollment Fairs throughout Cuyahoga County to help residents sign up for insurance — whether through Medicaid, Medicare or the federal marketplace.
“This board appreciates the many partners, especially in the faith community, who have already come forward and promised to help our patients navigate the complex process of enrolling in appropriate insurance,” said Dr. E. Harry Walker, chair of MetroHealth’s Board of Trustees, in a press release. “Working together, I believe we can build and sustain a healthier community.”
The hospital’s push comes right before the federal health insurance marketplace opens its enrollment on Nov. 1. Those insurance plans are expected to get pricier next year: in Ohio’s marketplace, premiums will rise between 13% and 17%, depending on what type of plan is selected, according to data from KFF. The federal government does offer subsidies based on income to help pay for the health insurance premiums, though some may be expire at the end of this year.
Bracing for federal, local cuts
MetroHealth is already struggling financially. It ended 2024 with $50 million in operating losses. But it’s preparing for even worse.
A federal bill President Donald Trump signed into law this summer will institute work requirements for certain people who have Medicaid, or government health insurance, for the first time in the program’s history. It’s not yet clear whether those will kick in in 2026 or 2027. But when they do, about 35,000 Cuyahoga County residents may need to begin working or lose coverage as a result, county officials estimated earlier this year.
The bill also requires residents with Medicaid to renew their coverage twice a year, instead of once a year. The county worries that will create more opportunities for residents to lose their health insurance.
The implications could have massive economic fallout for the health sector as a whole. Hospitals in Ohio could see about $10 billion less in spending between 2025 and 2034 as a result of the federal bill, one analysis by the Urban Institute found. And MetroHealth, with its significant population of Medicaid patients, is no exception.
The hospital could also see a smaller subsidy from Cuyahoga County to pay for charity care. The county executive proposed cutting the dollars it sends to MetroHealth by about 8% next year.
As it prepares for these changes, MetroHealth has pared back the amount of free care it will give away. Some people — such as those who earn between 251% and 300% of the federal poverty level — will see slightly smaller discounts on care.
“These changes ensure that charity care is preserved for those with no other options, while encouraging those eligible for coverage to take advantage of it,” the hospital said in a press release.
How to enroll in health insurance
The federal health insurance marketplace opens Nov. 1. Residents can view plans and their predicted costs at healthcare.gov.
Individuals who need assistance from MetroHealth to enroll in health insurance can call 216-MY-METRO (216-696-3876) and press option 5. They can also visit metrohealth.org/coverage for assistance.
Residents can also attend the upcoming health and enrollment fairs, hosted by MetroHealth. They will take place between 11 a.m. and 3 p.m.:
- Saturday, Nov. 15 | Broadway Health Center, 6835 Broadway Ave., Cleveland
- Saturday, Dec. 13 | MetroHealth Main Campus, 2500 MetroHealth Drive, Cleveland
- Saturday, Jan. 10, 2026 | Parma Ukrainian Parish & Banquet Hall, 6812 Broadview Road, Parma
To register for the events, visit metrohealth.org/mtcc.
Residents can also get health screenings, schedule appointments and meet with MetroHealth’s Financial Assistance Team at the community fairs.