Rep. Brewer Calls on Cleveland Clinic to Reverse Harmful Copay Policy Impacting Low-Income, Minority Communities

COLUMBUS — In response to Cleveland Clinic’s newly implemented policy requiring patients to pay copays upfront or risk having their appointments canceled, State Rep. Darnell T. Brewer (D-Cleveland) today issued a formal letter to Cleveland Clinic leadership requesting immediate reconsideration of the rule, citing the disproportionate harm it poses to low-income families, seniors, and communities of color across northeast Ohio.

“This policy is a dangerous barrier to care that punishes patients simply for being poor,” said Rep. Brewer. “It sends a clear message that if you can’t pay, you don’t deserve care—even if you’ve done everything right to schedule an appointment and show up on time.”

Recent reports from Cleveland.com highlighted how the new policy could lead to appointment cancellations for patients unable to cover out-of-pocket fees at the time of service. The timing of this shift coincides with the Cleveland Clinic being ranked one of the worst hospitals in America for community spending (first in Ohio and fifth in the nation) for its “fair share deficit” in the 2025 Lown Institute Fair Share Report. The nonprofit hospital system, despite receiving generous tax breaks, was found to be falling short in providing adequate benefits to the community.

Rep. Brewer's letter underscores the risk that the copay policy will lead more individuals to seek care in emergency rooms—a more expensive and reactive approach to health care. 

“Delaying routine or preventive care because of an inability to pay upfront is not only unjust, it’s inefficient,” said Rep. Brewer. “It drives up costs for hospitals, strains ERs, and worsens patient health outcomes.”

While the Cleveland Clinic has claimed $1.46B in community benefit spending across its operations, including $261M in free or discounted care in 2023, Rep. Brewer questions how much of that investment directly reaches the communities most in need—particularly in neighborhoods across Cleveland’s East Side and inner-ring suburbs, where healthcare disparities remain stark.

Rep. Brewer is requesting for a meeting with Cleveland Clinic leadership to explore alternatives to the copay rule and to encourage more meaningful community engagement.

“If the Clinic wants to remain a leader in global healthcare, it must also lead in equity and access right here in its own backyard,” said Rep. Brewer.

EDITOR’S NOTE: Rep. Brewer’s letter to the Cleveland Clinic is attached to this press release.