Officials in Cuyahoga County are bracing for big changes to Medicaid and the Supplemental Nutrition Assistance Program, or SNAP.
Elected officials, hospital leaders and nonprofit directors gathered with Cuyahoga County Executive Chris Ronayne September 8 to discuss the changes — the first step toward creating a strategy they hope will help maintain access to the programs.
One big upcoming change is how long people are covered by Medicaid, said Cuyahoga County Job and Family Services Director Kevin Gowan.
"Right now, individuals who sign up for Medicaid are good for a year," Gowan said. "After a year they need to renew. Under the new law, this expansion population has to renew every six months."
The new federal regulations were signed into law in July, and will take effect sometime before December 31, 2026.
The bill also establishes new work requirements for Medicaid expansion populations — those who became eligible under the Affordable Care Act. They would need to complete 80 hours per month of a minimum wage job, community service, a work program or an education program.
Also facing new work requirements are Cuyahoga County SNAP recipients, including about 25,000 adults between the ages of 55 and 64 and parents whose children are 14 and over.
The law would deeply affect new arrivals in the U.S. who rely on both SNAP and Medicaid, said Patrick Kearns, executive director of Re:Source Cleveland, a nonprofit serving immigrants.
“If we look ahead, it looks like there's a couple serious waves coming at us," Kearns said. "And I think that success is making sure that those waves are not a tsunami but something that's a bit more manageable.”
Officials said they plan to publicly share new strategies for helping people maintain access to the programs before regulations take effect by the end of 2026.
Before that happens, there needs to be a concerted effort to sign up more of the county's 40,000 uninsured people for Medicaid, said Romona Brazile of the MetroHealth System.
“So, part of what we have to do is a lot of intensive outreach. We’re talking a ground game," Brazile said. "And that is beyond phone calls and websites, but in really working with partners to reach people we need to reach.”
Only once the uninsured are signed up, she said, can the county try to preserve their access, she said.
MetroHealth recently laid off more than 100 employees in part because of anticipated Medicaid cuts.
About 380,000 Cuyahoga County residents are on Medicaid, including more than half of all the children in the county. About 190,000 residents in the county use SNAP benefits.
