Health system CEOs in Cleveland and across the country are facing numerous questions without clear answers, as they look ahead to the effects of the One Big Beautiful Bill Act, according to Becker’s Hospital Review.
In July, Congress passed nearly $1 trillion in Medicaid cuts over 10 years as part of President Donald Trump’s signature bill. The cuts could leave an estimated 11.8 million Americans without insurance, forcing hospitals to absorb more costs that were previously covered by Medicaid, according to analysts at UC Berkeley.
Proponents of the legislation argue the cuts will reduce fraud and ensure that only eligible individuals receive coverage. Critics warn hospitals will face mounting unpaid bills and may have to reduce services.
The severity of the financial hit on hospitals depends on several factors, including state policy, relationships with health insurance companies, local market forces and other factors, Becker’s said.
Some hospitals may use the One Big Beautiful Bill Act to implement overdue changes, such as getting rid of underperforming departments, relying more on AI or cutting administrative posts.
More people may skip or delay getting health care because of costs, loss of health insurance or long wait times. As a result, emergency rooms may have more patients and patients who are sicker and need more expensive treatments, Becker’s said.
MetroHealth this week became the latest NE Ohio hospital to take steps to deal with the looming economic uncertainty.
MetroHealth announced Monday it will close six outpatient centers in the Cleveland area as part of an effort to stabilize its finances.
The closures, effective Friday, Oct. 3, include:
- Broadview Heights Sports Medicine and Physical Therapy
- The dental clinic at Old Brooklyn Medical Center
- Medina Health Center
- Rocky River Medical Offices
- State Road Family Practice in North Royalton
- Westlake Physical Therapy at the West Shore Family YMCA
MetroHealth said the decision follows years of expansion that created overlapping services and inefficiencies. Consolidating operations will allow the system to provide more services in fewer locations, with some facilities extending their hours and many employees relocating to larger sites.
The move comes as MetroHealth faces soaring costs for charity care, which have doubled since 2022 and now exceed $1 million per day. Officials cited ongoing operating losses, higher expenses, and uncertainty around government funding as additional financial pressures.
The system recently laid off about 125 employees, mostly in administrative roles, and continues to notify patients if their providers or appointments are being relocated.
MetroHealth said that it will still operate more than 20 outpatient sites and remains committed to serving patients.
Looking ahead, MetroHealth plans to open a new Outpatient Health Center on its main campus in 2026, along with a drive-thru pharmacy in 2027. Construction of the health center, new parking garage, and other campus renovations is expected to cost $168.2 million.
Medicaid cuts add pressure
MetroHealth ended 2024 with $50 million in operating losses and projects even larger losses in 2025. Other major Cleveland health systems are also cutting costs: Cleveland Clinic eliminated 114 administrative positions earlier this year, while University Hospitals cut more than 300 leadership roles after closing two hospitals in 2022.
Although MetroHealth serves as Cuyahoga County’s safety net hospital, only part of its annual funding comes from the county. In November 2024, trustees approved a $2 billion operating budget for 2025, up from $1.9 billion the previous year. Cleveland.com