Table of Contents

Regional Reports

Committee Report

Recommended Reading

• New Report Sheds Light on How Often Insurance Corporations Use Prior Authorization to Deny Care
• Improved Medicare For All Will Save Our Rural Hospitals
• Living in an exhausted, morally distressed nation/Opinion
• Survey:  Health benefit costs expected to jump 8.2% in 2027, the biggest increase since 2003
• Changes to the ACA Marketplace for plan year 2027:  What you need to know
• To Boost Profit, Medicare Advantage Giants Move  Over a Million Seniors Off Their Plans
• Medicare for All: Where We’re Going and How We’re Getting There
• Ohio’s Already Seen the Biggest ACA Drop.  Premiums Are About to Go Up.  .  .
• Understanding medical frailty in Medicaid: What the New Interim Final Rule means for coverage
• Stunning  Level of Support for Universal Health Care: Rep. Jayapal  Even more people want Medicare for All than did last December, a new poll shows.
• Being a Doctor Will Never Be the Same after A.I.

Recommended Videos:

• Dr. Abdul El-Sayed speaking at SPAN annual conference 2022
• UnitedHealthcare and UnitedHealth Group:  Last Week Tonight with John Oliver

Regional Reports

Regional Coordinators, with their contact information, are noted. Please contact the Coordinator for your region if you would be interested in joining

Region 1 (Cleveland, Northeast Ohio)

Co-Coordinators:

Diane Howard  (216) 450-4561 howarddiane49@gmail.com  

Diana King  (216) 543-4545 dianakinghistory@gmail.com  

On July 30, Medicare’s birthday, we joined with others to go to Representative Shontel Brown’s Office to celebrate Medicare’s birthday by advocating for Medicare for All.

Afterwards, Rep. Brown posted the following message in her newsletter:

Cleveland HCFAO/SPAN held a successful fund-raiser this summer. It was held at Chef Carolyn’s Exotic Cuisine. About 50 people attended, and we raised about $2000 for HCFAO/SPAN. We had a great dinner, as well as awesome raffle baskets, and a band.  

During the brief program period, several individuals spoke of the problems obtaining adequate health care for themselves or loved ones, with a panel of doctors to comment on them.

Dr. Rehan Waheed speaking at our fundraiser about the People’s Distro and Clinic.

On Sept 19, we had a table at the Tremont Arts & Cultural Festival in Cleveland. We table at the Tremont Arts and Cultural Festival every year because we always talk to many people, some who join our email list and/or take home our literature.  This was the second consecutive weekend we had planned to table. We were rained out for the first, the Waterloo Arts Festival, and feared the same would happen in Tremont. It did rain, but we managed to set up our tent before the rain, weathered any rain, and enjoyed the afternoon’s clearer skies. Though the crowd was a bit thinner than in previous years, a steady stream of people came by our table. Each expressed agreement and appreciation of our work on behalf of universal, single payer healthcare for all.  

Our “Wheel of Misfortune or Fortune” attracted many people to our table. The game is simple but educational: Spin the wheel and the number you land on determines a scenario of either “Fortune” because it describes a situation where the country has single payer healthcare, or “Misfortune” which describes a scenario of high medical bills in our country without single payer healthcare.

 Our “Medicare for All” signs brought supporters who talked about their commitment to single payer healthcare and who thanked us for working on this vital issue.

HCFAO at Tremont Arts Festival.  From left to right, Anne Caruso, Nancy McCrickard, and  Brian Houlehan

The next meeting of Cleveland HCFAO/SPAN will be on Sunday, October 11, at 2:00 PM. We will have a social starting at 2:00 with light refreshments. Feel free to bring something to share, but it is not necessary. The business meeting will start at 3:00 PM.

The next meeting for the Healthcare for All Book Club is October 16 from 3:30 to 5 pm at the Cuyahoga County Public Library, Independence Branch , 6361 Selig Drive, Independence Ohio, 44131.  We are hoping to expand to other regions via Zoom.  

We will discuss Deficit How Feminist Economics Can Change Our Worldby Emma Holten.  For more information and details about these events, contact clevelandspan@spanohio.org.

Region 2 (Northwest Ohio -Toledo Area)

We have contacted all of our local Democratic representatives about the Medicaid Savings Act (MSA) and have universal support from our currently elected NW Ohio reps now and when we reintroduce it next session.  We have tried to meet with Senator Gavarone (R) but have had several meetings cancelled. We will keep trying. Carol Farris has been super helpful working on these meetings.

She is also getting the word out to local Democratic Party meetings. We met with the leaders of the Henry County Democratic Party this summer about the MSA and the likely problems with the cuts in Medicaid coverage and the impact of that on patients and hospitals in rural areas of Ohio. We have a planned meeting with Monroe, Michigan Dems to promote the Michigan single payer bill (MiCare) and to encourage them to consider a Michigan version of the MSA.

We also have a meeting to discuss the Healthcare for all Ohioans Act and the MSA with the Huron County Dems scheduled for October 29 in Willard, Ohio. John Ross will be attending the APHA and PNHP meetings and will speaking about the MSA at both and about other good incremental health reform ideas.

Region 3 (Southeast Ohio)

Coordinator: Beth Workman  (614) 233-1406  region3@healthcareforallohioans.org

Region 4 (Cincinnati, Southwest Ohio)

Co-Coordinators:

Chot VanAusdall (513) 617-5129  vanausdall@fuse.net

Suzanne Fuhrman (513) 399-7534    region4@healthcareforallohioans.org            

Region 4 members have continued outreach, lobbying, and community education across southwest Ohio. On the legislative front, we have been talking with lawmakers and advocates about the Medicaid Savings Act in partnership with the Ohio chapter of Physicians for a National Health Program. We’ve learned it will likely be reintroduced in the next General Assembly, which begins in January. We are planning to keep pressing committee leadership for meetings in the upcoming months. Members gave talks at lunch-and-learn events, as well as met with local allied organizations.

We’ve stayed active in the community through tabling at the Festival of Faiths, Lebanon Pride, and the Stricker’s Grove labor picnic. Members took part in a Warren County event, a vigil for Haitians, and a Working Families Party event. We met with the Greater Cincinnati Homeless Coalition and are building relationships with groups like Interact for Health, Defend Public Health, and rural organizations working in Clinton and Warren counties.

Every conversation reinforces why this work matters, and we’re glad to have so many members involved. If you’d like to help with outreach, join an upcoming event, or take part in any way, we’d love to get in touch.

Our next Region 4 meeting is Wednesday, October 14, at 7 PM. Contact  region4@healthcareforallohioans.org for details.

Kendall Mays receiving the Generosity Award in Warren County

                                                                                                                                                                                                           Mary Ann Kokenge and Leslie Jump at the Festival of Faiths

Region 5 (Columbus, Central Ohio)

Coordinator: Mayo Makinde  (614) 233-1406  region5@healthcareforallohioans.org

Region 5 is gearing up for the Circleville Pumpkin Show Parade on October 3, 2026!  A big red pickup truck decked out with our banner and signs will lead the way, with members riding in the truck bed and walking the parade route to share our message with the community.  A big thank-you to Marilyn Webster, Arlene Sheak, and Kurt Bateman for bringing this effort to life—and to Region 3 Coordinator Beth Workman for inviting members from her region to join the fun.

Region 5 members also closed out the summer with action, meeting with several state lawmakers to champion the Ohio Health Care Plan Act and the Medicaid Savings Act.

Our Region had our last meeting on July 23rd and we also are planning to be a very active participant at the Circleville October Pumpkin Festival on Saturday, October 24th.

With federal cuts to Medicaid and Medicare scheduled to take effect on January 1, 2027, the stakes are high. We must keep urging our state representatives and senators to respond through meaningful state legislation.  One lawmaker captured the urgency perfectly: “We need to hit the ground running in the next Ohio General Assembly.”

Get involved: Join us at an upcoming Region 5 meeting, bring a friend, or help spread the word.  Every conversation builds momentum—and together, we can move Ohio closer to health care for all.
Region 6 (East Central Ohio-Akron/Canton/Youngstown/Mansfield area)

Coordinator: Jennifer Lopez (614)  633-6689  jenniferlopez01@myyahoo.com

Region 7 (West Central Ohio-Dayton area)

Co-coordinators:

Matthew Noordsij-Jones, MD  (614) 233-1406  region7@healthcareforallohions.org

Bill  Davis (614) 233-1406   region7@healthcareforallohioans.org

Committee Reports

Membership Committee Report

HCFAO/SPAN Ohio thanks Bill Davis for over ten years of dedicated service as the Membership Chairperson! Bill has filled an important role in the organization, maintaining membership records, processing dues, and mailing out member cards. The success of grassroots volunteer organizations depends upon its members, and the Membership Chairperson is the hinge pin of success. Thank you, Bill. for sustaining and growing our group for more than a full decade. Your perseverance is respected, commendable, and will carry you forward in new interests.

The Membership Committee is now seeking a new chairperson. Only a one or two

-year commitment for service is expected, but like Bill, you may find it is a role you choo

se to continue. With help from the newly formed Mobilization team, the Chairman’s role will have more support than ever. It is a great position to get to know others in the organization. You can call Bill (at 937-264-0377) for more information, or email Kurt Bateman (at span@spanohio.org

) to express your interest in serving.

     The primary responsibilities of the Membership Chair are maintaining accurate membership records; verifying when dues are paid; knowing and following the organization’s by-laws, and participating in State Council meetings. It would be helpful to know or be willing to learn record-keeping software tools. A knack for organization and communication will prove beneficial too.  Volunteer now!

Lobby Committee Report

Our Lobby Committee has grown to 28 members!

1)  In May 2026 The Medicaid Savings Act had sponsor testimony hearings in the House and Senate Medicaid        Committees.

House sponsor, Representative Karen Brownlee and Senate joint sponsors, Senators Bill Blessing and Beth Liston,  gave compelling testimony for the enactment of the bill.

Members of the Lobby Committee working with other HCFAO members who wish to lobby are working with Ohio PNHP  and SNaHP members.

We have recruited over 80 people for this effort.

We have noted a lot of excitement around the Medicaid bill among our members.

There have been several training sessions held for those lobbying re:

      1) details of the bill

      2) effective lobbying

To date we have held meetings with 22 State Representatives and 9 State Senators, with approximately 21 legislators  overall expressing support for the Medicaid Savings Act.

There is significant bipartisan support.

Palm Cards developed by HCFAO’s Marketing Committee for general distribution.

A more detailed Fact Sheet about The Medicaid Savings Act was recently developed by Bob Parker and Phil Lichtenstein and another by John Ross.

We are distributing it as well as we reach out to the public around the state.

2) We have met with 9 candidates running for State House of Representatives and 1 running for State Senate, to inform them of our work both on the state single payer bill and currently on the Medicaid bill.

All of those candidates have expressed support for these state bills.

3) We have continued to meet with U.S. Congresspersons and those running for Senate and Congress regarding Medicare for All.

Submitted by Dee Chavez

Chair Lobby Committee

Marketing Committee

The Marketing Committee meets on the last Sunday of each month at 7:00 PM.  We would love to have anyone join us. Please email mindy.hedges@gmail.com

Recommended Reading

From the newsletter of the Alliance for Retired Americans, AFL-CIO senior group, September 11, 2026:

New Report Sheds Light on How Often Insurance Corporations Use Prior Authorization to Deny Care

New Report from the Kaiser Family Foundation found that in 2025, insurers denied 12 percent of standard prior authorization requests under Medicare Advantage, 14 percent under Medicaid managed care, and 18 percent under Affordable Care Act (ACA) Marketplace plans.

Patients have the ability to appeal denials, but these appeals aren’t often granted: insurers overturned 67 percent of appealed denials under Medicare Advantage, 47 percent under Medicaid managed care, and 43 percent under ACA Marketplace plans.

“Every day waiting for approval can be a matter of life and death for older Americans. This data showcases why adding prior authorization processes for traditional Medicare is dangerous,” said Joseph Peters, Jr., Secretary-Treasurer of the Alliance. “Congress must take action to repeal the Administration’s WISeR prior authorization pilot program.”

.    .    .

New Report Sheds Light on How Often Insurance Corporations Use Prior Authorization to Deny Care

Improved Medicare for All Will Save Our Rural Hospitals

At long last, the nations healthcare plan with guarantee that not only is everyone covered, free at the point of service, but there is a place within reasonable distance to find care.

By Kay Tillow, Sept 19, 2026 Common Dreams

After a century of providing healthcare to this rural, southeast Michigan community, Sturgis Hospital closed in June with only 70 hours warning.

The hospital was not on the at-risk-of-closing list that had been published by Sen. Ed Markey (D-Mass.) a year earlier.

Over 300 Sturgis Hospital employees are scrambling to find work. Registered nurse Beth Kelley, who had worked at Sturgis for 32 years, described the meeting room as filled with “shock” and “devastation” when management announced that the hospital was closing.

Nationwide more than 700 rural hospitals are at risk of closing, over half at immediate risk within the next two to three years. The 700 hospitals represent about one-third of all rural hospitals.

. . .

With passage of H R 3069, Improved Medicare for All, finally, the nation will take responsibility for assuring that rural areas have adequate facilities. Hospitals will be paid quarterly, in advance, with a global budget that provides operating expenses.

The allocation to hospitals ensures proper staffing with safe nurse-to-patient ratios and optimal staffing for physicians and other healthcare workers. Physician salaries can be included in the global budget. Adjustments to the operating budget will be made “to decrease healthcare disparities in rural or medically underserved areas.”

Improved Medicare Will Save Our Rural Hospitals

Living in an exhausted, morally distressed nation/Opinion

by Connie M. Ulrich, Mary D. Naylor, and Martha A.Q. Curley We are overwhelmed by the constant barrage of toxic messages and distressful events that shape our sense of who we are as a society and negatively affect our physical and mental health.

This is not us.

This is not the America we thought we were. As nurses, we’re sensitive to negative shifts in compassion and empathy. Almost two years of multiple, relentless attacks on America’s core values have left us morally distressed. We have seen, and some have personally experienced, the horrific public health impact of the resurgence of preventable diseases and deaths from measles, a disease that had been eradicated from the U.S.  

As a nation, our actions are out of alignment with our values.   .    .    .

Living in an exhausted, morally distressed nation/Opinion

Survey: Health benefit costs expected to jump 8.2% in 2027, the biggest increase since 2003  

Total health benefit cost per employee is expected to rise 8.2% on average in 2027 — the highest increase since 2003 — even after accounting for planned cost-reduction measures. Employers said that the cost of their current plans would increase by 11%, on average, if they took no action to lower it.

Based on these projections, 2027 will be the fifth consecutive year of elevated health benefit cost growth after a decade of more moderate annual increases. It will also be the highest increase in this five-year period. The average projected increase for 2026 was 6.7%.

.    .    .  https://www.mercer.com/en-us/

CHANGES TO THE ACA MARKETPLACE FOR PLAN YEAR 2027: WHAT YOU NEED TO KNOW

The U.S. Department of Health and Human Services (HHS) released the final 2027 Notice of Benefit Payment Parameters (NBPP) rule on May 18^th. Termed the “ACA final rule,” the over 1,000-page text may be found online in the Federal Register. The rule addresses how health plans will be structured and offered on the Affordable Care Act (ACA) Marketplace (also known as “Exchanges”) in 2027 and beyond. HHS estimates that the rule will decrease insurance enrollment by up to 2 million people for 2027; this is due to more burdensome income reporting and verification requirements estimated to cost taxpayers about $1.34 billion each year to implement.

Overview

The 2027 ACA final rule guides insurers on plan offerings for open enrollment beginning in Fall 2026. This year’s rule makes significant changes to the plans available to people purchasing their coverage through the ACA Marketplaces. Below are key changes and anticipated impacts.

Key Points:

• Expands the role of catastrophic health plans, making them more accessible and allows longer enrollment periods, while maintaining very high out-of-pocket costs.    .   .   .
• Increases the paperwork and verification requirements for ACA coverage, especially for very low-income earners who may lack a credit report or tax filing.
• Positively, requires all agents and brokers to use a uniform consent form and broadens oversight to reduce inappropriate enrollment, misleading marketing tactics by brokers and agents and fraudulent access to premium tax credits.  

• Allows states to review, redefine and certify who counts as essential community providers (ECPs) and changes the requirement for how many of these providers must be included in health plan networks to meet a standard of “sufficient access.” This will translate into fewer contracted safety net providers for patients and could lead to longer patient wait times and increased travel time.  
• Eliminates standardized plans that create apples-to-apples comparisons for patients when they are shopping for a new health plan on the Exchange.
• Permanently ends a special enrollment period (SEP) for low-income people and bans undocumented immigrants and other low-income immigrants, even if lawfully present in the country, from receiving subsidies in alignment with H.R.

.   .    .  
Changes to ACA Marketplace – What You Need to Know

To Boost Profits, Medicare Advantage Giants Move to Kick Over a Million Seniors Off Their Plans.    

Humana said it is exiting plans covering roughly 600,000 seniors to “drive the intended margin expansion”

by  Jake Johnson, senior editor and staff writer for Common Dreams

Two of the largest Medicare Advantage insurers in the US, UnitedHealthcare and Humana, have signaled in recent days that they plan to exit certain “underperforming” markets and curb benefits in an effort to boost their bottom lines, a strategy that’s expected to kick more than a million seniors from their coverage.

.    .    .  

“UnitedHealthcare—the largest MA insurer in the US—offered plans in one fewer state and 109 fewer counties this year, cut allowances for certain over-the-counter health and wellness items, and prioritized plan designs with more limited provider networks,” Healthcare Dive noted. “The company also shifted commissions to brokers to incentivize enrollment in more profitable plans.”
As for Humana, the company’s chief financial officer said during an earnings call in late July that its exit from certain markets and dropping of specific plans would “impact approximately 600,000 members” as the firm implements “the changes necessary to drive the intended margin expansion.”
.   .    .  

https://www.commondreams.org/news/medicare-advantage-benefit-cuts

Medicare for All: Where We’re Going and How We’re Getting There

by Nancy J. Altman

Health care should be available to everyone in America as a right—automatic and free of charge when we need it. Rich or poor, sick or healthy, old or young, no matter where you live, everyone should have high-quality health care.

Editor’s Note: The following is an excerpt from Nancy J. Altman’s latest book, The Road to Medicare for All: A Call to Action (Routledge, 2026), published today and now available for purchase wherever quality books are sold. As the United States continues to spend substantially more on health care than other wealthy nations but with poorer health outcomes, Altman’s book analyzes the dysfunction of the current system and sets forth the solution.

“Medicare for All  won’t happen without a fight,” she argues, “but it is a fight we can win.”

.   .   .

Reaching our destination won’t be easy. Americans have been fighting for universal, government-sponsored national health insurance for over 100 years. Progress was made in 1965 and 1972, when Medicare was enacted and expanded. Since, then, though, not only was Medicare not expanded; frustratingly, its opposition has succeeded in partially privatizing it.

Ohio’s Already Seen the Biggest ACA Drop.  Premiums Are About to Go Up…

Mary Schladen, The Ohio Capital Journal

Ohio has seen the biggest enrollment drop of any state since congressional Republicans allowed subsidies for insurance in Affordable Care Act marketplaces to expire, nearly by a third of the half-million Ohioans who bought insurance there dropped it.

Now, faced with a smaller, sicker clientele, the 11 insurers remaining in Ohio’s marketplace are proposing to increase premiums on average by 14.7% for 2027, according to an analysis by the Center for American Progress.

Natasha Murphy, the group’s director for health policy, said the new expense will only add to the burden besetting hundreds of thousands of Ohioans who are already struggling to get by.

“It’s just exacerbating the affordability crisis that millions of Americans are finding themselves in — especially as it relates to their monthly premiums,” Murphy told the Capital Journal.

.   .    .  Ohio’s Already Seen the Biggest ACA Drop. Premiums Are about to Go up

Understanding medical frailty in Medicaid: what the New Interim Final Rule means for coverage

by Carmen Harris, Public Policy Fellow

For the first time in Medicaid’s history, adults ages 19-64 who are enrolled through Medicaid expansion will be required to complete and document at minimum 80 hours of qualifying activities per month, or risk losing their coverage. This, according to the provisions of H.R. 1, better known as the “One Big Beautiful Bill” Act, signed into law on July 4, 2025. The Centers for Medicare and Medicaid Services (CMS) will implement work requirements beginning January 1, 2027.

The new requirement ensures that certain populations are exempt from work requirements, including individuals who are considered medically frail. However, a point of contention since the release of CMS’s Interim Final Rule (IFR) this past June has been its definition of medically frail. Although there are exemptions for medically frail individuals, advocates, health policy experts, and even some states question whether CMS’s interpretation of congressional intent creates a more nuanced and restrictive standard.

The concern is that the IFR requires individuals not only to demonstrate that they have a qualifying condition, but also that their condition impairs their ability to meet the work requirements—potentially making it more difficult for those individuals with serious health conditions to qualify as medically frail. This raises three important questions:

1. How will states determine medical frailty?
2. How do individuals qualify for the medical frailty exemption?
3. What can individuals do to prepare for this change?

.  .  . Understanding Medical Frailty in Medicaid

‘Stunning’ Level of Support for Universal Health Care: Jayapal

Even more people want Medicare for All than did last December, a new poll shows.

Medicare for All is a winning policy supported by the vast majority of Democratic voters that can give the party a boost, including in battleground states, according to a new survey from Rep. Pramila Jayapal (D-WA) and her political action committee.

The Medicare for All PAC survey found that not only do 94 percent of Democratic voters support a universal public health insurance program, but so do a majority of moderate and independent voters. It also found that Medicare for All is a winning issue in battleground states, where Jayapal said progressives are constantly told to moderate their messaging on universal health care. . . .‘Stunning’ Level of Support for Universal HealthCare: Jayapal

Being a Doctor Will Never Be the Same After A.I.

by Rachel Bedard

My patient care has improved as conversations with the agent push my thinking beyond its usual limits. For the residents I supervise, however, the app’s speed and anticipatory helpfulness are a hindrance as much as an enhancement.

I have a confession: A.I. is making me a better doctor .  And I worry that it’s making doctors-in-training worse.

Amid our recent doom cycle about whether A.I. will lead to extreme societal harms. a parallel anxiety has taken hold in medicine about whether A.I. will one day replace physicians.    .   .   .

Being a Doctor will never be the same after A.I

Videos

• Physician, epidemiologist, educator, author, speaker, podcast host, and now the Democratic candidate for the US Senate from Michigan, Dr. Abdul El-Sayed talks with SPAN activist Johnathon Ross about his life and work that convinced him a Universal National Healthcare System is essential in the US. His insights into our broken system are invaluable for those of us working for radical change. He was a keynote speaker at the SPAN annual conference four years ago.   Dr Abdul El-Sayed interview
• UnitedHealthcare and UnitedHealth Group:  Last Week Tonight with John Oliver (34 minute video).  Last Week Tonight With John Oliver-UnitedHealthcare

HCFAO/SPAN OHIO LINKS

Healthcare For All Ohioans/SPAN Ohio (HCFAO/SPAN Ohio):

http://spanohio.org/

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To send articles, events, letters or comments to this newsletter, please email the Communications Committee (Cindy Bamford (Co-chair), Linda Brown, Tim Bruce, Brian Houlehan, Dena Magoulias and Bob Parker (Co-Chair)).

The email address is:

ClevelandSpan@SpanOhio.org.  This newsletter is posted under Resources.

SPAN exists due to the generosity of individual donors. Please consider a donation today:  Donations   SPAN Ohio is a 501(c)4 non-profit organization. Donations to SPAN Ohio are not tax deductible.   Follow us on Twitter. Like us on Facebook.