Ohio Is About to Lose $33 Billion in Medicaid. Ask Who Was Using It.

News / Health and Power — REAL POWER.TV

Nearly one in three people in Cuyahoga County is on Medicaid. Now do the math on a $33 billion cut.

There are 379,137 Medicaid enrollees in Cuyahoga County. That is 30.3 percent of everybody who lives here — almost one in three of your neighbors, according to the Health Policy Institute of Ohio’s analysis of state Medicaid data.

Ohio is projected to lose about $33 billion in federal Medicaid funding between 2025 and 2034 under H.R. 1, the federal law known as the One Big Beautiful Bill. That figure comes from Georgetown University researchers working off Congressional Budget Office and KFF estimates, and Policy Matters Ohio has put the same number on it.

Thirty-three billion dollars does not evaporate. It comes out of somebody. The only question worth asking is who.

How the Money Actually Leaves

Not in one cut. In rules.

Starting January 1, 2027, adults 19 to 64 in the Medicaid expansion group have to document 80 hours a month of work or study, verified every six months. Eligibility reviews for that group move from once a year to twice. Policy Matters Ohio estimates somewhere between 319,000 and 493,000 Ohioans are at risk of losing coverage by 2034 — most of them not because they stopped qualifying, but because paperwork due twice a year finds people who move, change jobs, or never got the letter.

Statewide the picture is bigger than the expansion group. More than three million Ohioans — about a quarter of the state — are covered by Medicaid. Georgetown researchers project roughly 340,000 Ohioans will lose Medicaid or marketplace coverage altogether, some 290,000 of them through the Medicaid changes alone.

Ohio hospitals are projected to lose $22.4 billion in Medicaid spending across the same window. Rural Ohio loses $5.62 billion, seventh worst in the country.

The decisions run through the Ohio Department of Medicaid, a cabinet agency reporting to the governor. Gov. Mike DeWine nominated Scott R. Partika to direct it last October, succeeding Maureen Corcoran. That is the office to call, and the name to know.

What It Looks Like on Euclid Avenue

Take the abstraction down to one building.

The Even Kings Feel Healing Community operates out of 4415 Euclid Ave. Its CEO and founder, LaToya Logan, MSSA, LISW-S, says the organization has served more than 13,000 Black boys and men over the past decade. Many of its clients are on Medicaid — including Antonio Davis, 41, who told Signal Cleveland he relies on it.

The organization does the work most systems say they want and rarely fund. It recently launched a violence intervention and healing justice department built to go at the root causes of community violence instead of treating the aftermath. It holds its third annual Suicide Prevention Summit on September 25. It is running research interviews with 75 incarcerated Black men on restorative justice.

And it argues something that ought to be obvious by now: a Black man who has spent forty years being told to handle it is more likely to sit down with a clinician who does not need that explained.

“Healing is not a luxury,” Logan said. “It is critical for a healthy community.”

The Squeeze Underneath the Squeeze

Here is the part that will close doors before the Medicaid cuts ever land.

Ohio requires behavioral health providers to carry national accreditation. That accreditation can cost more than $12,000. It is a reasonable-sounding rule applied evenly to everyone, which is exactly how it does its damage: many small Black-led behavioral health organizations in this state operate on annual budgets of $15,000 or less.

Put those two numbers next to each other and you can see the whole mechanism. A mandate that a hospital system absorbs without noticing is, for a neighborhood provider, most of the year’s money. Nobody has to decide to shut these organizations down. The cost structure does it, quietly, and everyone gets to say the rule applied to all.

Stack that on top of county social-service reductions and a $33 billion federal withdrawal, and you are not looking at a budget story. You are looking at the removal of an entire layer of care that took a decade to build, from the people least able to replace it.

Who Pays

When a provider like this closes, its clients do not stop needing care. They show up somewhere else — an emergency room, a county crisis bed, a courtroom, a jail. All of those cost more than the therapy would have. All of them are also paid for with public money. The bill does not disappear. It moves to a more expensive address and arrives later, which is the only reason this ever passes for savings.

And the men who were finally showing up, who took years to walk through a door, mostly do not come back.

What To Watch

Three things between now and January 2027. Whether Ohio seeks a good-faith delay on the work requirements. Whether the state builds a verification system that people can actually use, or one that quietly does the disenrolling for it. And whether Cuyahoga County holds its own social-service funding steady while the federal money goes.

The Even Kings Feel Healing Community’s Suicide Prevention Summit is September 25. Show up to that one, and you will meet the people this decision lands on before the decision lands.

If you or someone you know is in crisis, the 988 Suicide and Crisis Lifeline is free and confidential, 24 hours a day — call or text 988.

The Power Desk · September 16, 2026

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