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MetroHealth Presses County to Restore Funding as 2026 Budget Projects $31 Million Deficit

Leaders say a charity care surge makes even a modest subsidy cut risky to reserves as well as bond covenants.

Overview

  • Cuyahoga County Executive Chris Ronayne’s budget proposes reducing MetroHealth’s subsidy from $35 million to about $32 million in 2026 and $33.5 million in 2027.
  • CEO Christine Alexander-Rager asked council to reverse the cuts, saying the system can withstand them but warned of potential reserve drawdowns and fewer residents receiving charity care.
  • Charity care has roughly doubled since 2022, with $275 million spent in the first nine months of 2025 and projections of $367 million for 2025 and $446 million for 2026.
  • Trustees approved a $2.2 billion operating plan for 2026 with a projected $31 million shortfall after an expected $48 million loss in 2025, though Q3 2025 showed a $6.8 million operating gain.
  • MetroHealth has cut 125 jobs, closed six outpatient sites, frozen hiring, reduced executive pay, revised its charity care policy, and plans to close its psychiatric emergency department by Dec. 31 as leaders debate responsibility for that closure.