With contributions from Daniel Cohn.

Mt. Sinai’s mission is to support organizations throughout Greater Cleveland that improve the health and well-being of the Jewish and general communities. The Foundation focuses on primary prevention and early intervention, especially protecting and improving the health of people from communities that have been historically marginalized.

Like many health care conversation foundations, one of Mt. Sinai’s key strategies has centered around expanding and protecting the health care safety net. Toward this end, the Foundation has funded efforts that have not only contributed to statewide Medicaid expansion stemming from the Affordable Care Act, but it has also protected health care access in the years since.

In its earliest efforts, during which time expansion was politically difficult, the Foundation made grants to both advance the cause and combat competing policy priorities. For example, the Foundation funded nonpartisan policy research and analysis that laid out the favorable economic outcomes that would result from expanding Medicaid; namely, both improved population health and the draw-down of hundreds of millions of federal dollars to offset health care costs.

At the same time, Mt. Sinai partnered with faith-based community organizers throughout Greater Cleveland to elevate the voice of congregations making the moral case for enhancing access to clinical care. This work was instrumental in giving the then-Governor the pathway needed to deflect political arguments against expansion. Thereafter, Mt. Sinai staff led statewide efforts to support outreach and enrollment through a web of navigators and assistors throughout Ohio.

Beyond their work on expansion, Mt. Sinai’s grantmaking strategy in health policy centers on bolstering the advocacy ecosystem in Ohio. For example, the Foundation co-founded the Health Policy Institute of Ohio, which has become elected officials’ go-to resource on all things health policy. Mt. Sinai has founded and supported numerous coalitions and advocates, has taken part in direct advocacy with federal, state, and local officials, and has funded strategic litigation as well as legal research all with an eye toward protecting expansion and defending against policies that would reduce health care access. These efforts, of course, also including funding grassroots organizers who elevate the voice of Ohioans directly affected by Medicaid policy.

Prior to the pandemic, Mt. Sinai was going on the offensive in pushing state policymakers to think more critically about the role Medicaid could play in upstream disease prevention and early intervention. Mt. Sinai staff have worked with state government to invest in affordable, healthy housing and have submitted multiple briefs, letters, and written testimonies on opportunities for health care financing to improve health-harming social conditions. The pandemic and ensuing economic turmoil may shift their focus to protecting gains against state-level budgetary restrictions, though hope remains for broadening the vision of what Medicaid expansion could mean for Ohio in promoting health, rather than simply treating disease.