Cleveland’s safety net hospital could close, Mayor Justin Bibb says

CLEVELAND, Ohio — Mayor Justin Bibb predicted in a recent Politico interview that MetroHealth System could “go out of business” if the federal government cuts Medicaid funding to hospitals.

“Cleveland is home to our only safety net hospital, Metro Hospital (sic), and they could go out of business if these cuts go through,” Bibb said in the interview.

MetroHealth declined to comment on Bibb’s dire prediction about its future. The medical system said it would wait to weigh in until it sees the impact of the Medicaid cuts, according to Rita Andolsen, vice president communications and media relations.

“We’ve been here for a long time — 200 years almost — taking care of our community and taking care of our patients, and we will continue to be here,” Andolsen said.

Cuyahoga County is backing MetroHealth’s billion-dollar campus transformation, including the new Glick Center, with a $64 million letter of credit — the value of MetroHealth’s annual debt payment. But even amid financial turmoil, the hospital says it is not likely to have to draw on the county’s credit.

Cleveland.com reached out to Bibb’s mayoral campaign to find out what data Bibb used to reach this conclusion.

Bibb was referring to the largest Medicaid cuts in the program’s 60-year history, which Congress passed in July as part of President Donald Trump’s “Big Beautiful Bill,” healthcare analysts said. The bill included cuts to Medicaid of almost $1 trillion over the next 10 years, according to health policy experts at UC Berkeley Public Health.

“What’s striking is that [Trump] worked to put some provisions in this bill with Republican senators to help rural hospitals, but nothing to support urban hospitals,” Bibb continued in his recent interview. “That’s going to decimate our public health infrastructure.”

Bibb told Politico that said he would convene a meeting of hospital and healthcare CEOs, as well as foundation leaders, to find ways to support Medicaid and Cleveland health care.

He also said he would promote preventative care, deploy the city’s mobile health clinic and work with MetroHealth to get patients enrolled in Affordable Care Act plans.

While MetroHealth didn’t directly address Bibb’s prediction, it is facing serious headwinds and has taken steps aimed at fixing its financial problems.

The latest moves are proposed changes to the health system’s charity care program as daily costs have doubled since 2022, now exceeding $1 million per day. The Cleveland-based health system aims to reduce free or discounted bills for some uninsured patients while intensifying efforts to help patients obtain insurance coverage.

The proposed changes would primarily affect middle-income uninsured patients, while maintaining current benefits for the lowest and highest income brackets. For instance, families earning between $80,000 and $96,000 annually, who currently receive full coverage, would see their subsidies reduced to 75% of medical costs under the new plan.

“That’s why we’re taking these steps now — primarily the education and awareness around enrollment — so that people who have fallen off the rolls of the insured can get insurance again,” Andolsen said. “If people are enrolling (in health insurance), then that leaves charity care for those who really need it most.”

The health system has already implemented cost-cutting measures, including employee layoffs and closure of outpatient offices, due to financial pressures from increasing uninsured patients and anticipated Medicaid cuts.

Under the proposed policy, patients must participate in financial counseling to receive full benefits. Those who decline counseling would receive 65% coverage of their medical costs, regardless of income level.

The changes would only affect Cuyahoga County residents, though MetroHealth is considering updates to policies for non-county residents. The implementation date and projected financial impact haven’t been determined, as the final outcome depends on successful insurance enrollment rates.

“Our goal is to make sure that we reserve our charity care for those with the greatest needs,” said Nikki Davis, vice president for revenue cycle.

The proposal, which remains under discussion following community forums and an August board meeting, aims to align MetroHealth’s discount structure with other hospitals while maintaining its core mission of providing care regardless of ability to pay.

AI was used in the writing of this story.