The pressure building inside Ohio's safety-net hospitals
Dispatches from the picket line outside a small hospital in Lorain, Ohio.
Back on April 1, in a steady Northeast Ohio downpour, the nurses of Mercy Health Lorain, represented by SEIU District 1199, picketed outside the hospital to draw attention to staffing shortages and unsafe conditions. By April 10, those nurses had ratified a new contract, ending a brief but pointed labor dispute.
The agreement they approved included wage scale adjustments tied to longevity, commitments to address security concerns, and increased pay differentials for certain roles. The agreement resolved the contract for now, but it didn’t resolve the strain that led to it.
“Since COVID started, it’s mostly short-staffed,” Sue Reinhardt told me. She’s a nurse who has worked at the hospital for 30 years. “It’s stressful from the time you get there to the time you leave.”
I wanted to talk with Reinhardt because I’d read in late March that Mercy Health Lorain was apparently at great risk of closure. And it wasn’t just Mercy Health. No big surprise here, but a national analysis by Public Citizen insisted that cuts of Medicaid in the 2025 “Big Beautiful Bill” in Washington were leading to a wave of imminent hospital closures. This funding crunch is particularly weighted toward those safety net hospitals, those entities that treat everyone who walks in—especially low-income and uninsured patients—often with less reliable funding to support that care. The report flagged 10 Ohio hospitals, including Marymount Hospital in Garfield Heights and Euclid Hospital in Euclid, as financially vulnerable, mostly because they’re already operating on thin margins while serving a high share of Medicaid patients.
Hospitals run on a simple but unforgiving math problem. Their costs stay high no matter what: staff, equipment, emergency rooms, beds that have to be ready whether they’re full or not. Programs like Medicaid and Medicare pay for a large share of patients, especially at those safety-net hospitals, even more so for the smaller outpost hospitals outside of city centers. When those payments get cut, hospitals are doing the same work for less money. The bills don’t shrink, but the revenue does.
