Roughly 60 community health centers exist in Ohio, providing care for many patients regardless of their health care coverage status.
Area federally qualified health centers say the major components of changes to Medicaid won’t truly impact them until 2027. But anxiety exists about patients falling behind on needed health care due to confusion about their benefits.
“I think that’s what scares us the most — there are so many things that if we see patients early enough, we can help them with their primary care needs,” said Five Rivers Medical Centers founder and CEO Gina McFarlane-El. “When people are afraid, they kind of retreat versus being proactive.”
In July, President Donald Trump signed the One Big Beautiful Bill Act into law, which includes changes to work requirements and increased frequency of Medicaid redetermination. Proponents of the changes say the tightening of rules will reduce fraudulent activity.
A total of 59% of Five Rivers patients are enrolled in Medicaid. Patients who rely on Medicaid, according to the National Association of Community Health Centers, include children, seniors, veterans and many other vulnerable populations.
The system of health centers provides medical, dental, vision, behavioral health, substance abuse, sports medicine, pharmaceutical and other services. Five Rivers Medical Center is the largest community health center in Montgomery County and the only center of its kind in Greene County.
McFarlane-El said Five Rivers screens patients for their needs when they visit a Dayton-area health center. From 2018 to now, the top reported obstacles for Five Rivers patients have been transportation, stress, housing and social isolation.
According to the Ohio Department of Medicaid, Montgomery County had 165,802 reported Medicaid enrollments as of June. This constitutes 31% of Montgomery County’s population.
And 13% of Five Rivers patients — a population that continues to grow, McFarlane-El said — are uninsured. These patients can pay for health services on a sliding fee scale.
“Our goal is to see everyone, regardless of their ability to pay,” McFarlane-El said.
According to the Center for Community Solutions, a Cleveland-based policy organization, changes in the way states can fund Medicaid by limiting taxation on certain types of providers will begin in 2026.
But new work requirements and new rules surrounding how frequently a recipient must prove their eligibility will go into effect in 2027.
McFarlane-El said she encourages Five Rivers patients to open up letters they may now be receiving about their health insurance. Outreach enrollment counselors can help them navigate questions about their Medicaid benefits.
“Our hope is that we can erase that fear,” she said. “I think helping to educate people about what resources are available is important. We can navigate this together.”
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