Beginning August 1, the Ohio Department of Medicaid (ODM) began denying all Fee-For-Service claims submitted without prior authorization. This sweeping bureaucratic policy change, which places an enormous administrative burden on providers, threatens to gut access to life-saving mental health and disability services for thousands of low-income Ohioans — and disturbingly echoes the logic of eugenics-era public policy.
The new rule arrives under the watch of a Republican-controlled legislature and conservative executive leadership in Ohio, part of a broader national trend of stripping public systems under the banner of “efficiency” and “cost control.” What remains unspoken is who pays the price.
Let’s call this what it is — structural violence. By making it nearly impossible for providers to serve Medicaid clients, this policy pushes people with mental illness, disabilities, and chronic conditions out of care — and possibly out of life.
A legacy of harm repeating in bureaucratic form
Though no one is openly using the language of eugenics, the impact is frighteningly similar. Eugenics movements of the past sought to reduce the reproduction and survival of those deemed “unfit.” Today, we see policies that disproportionately deny care to the very people eugenicists once targeted: the poor, disabled people, the mentally ill, and people of color.
This is not accidental — it’s engineered neglect. It doesn’t need violence to destroy lives; it only needs red tape.
The Conservative Policy Machine and the Politics of Exclusion
This shift aligns with a growing national conservative movement that:
- Attacks access to reproductive and gender-affirming health care,
- Criminalizes homelessness and mental illness,
- Promotes privatization of public programs at the expense of the vulnerable.
In Ohio, these Medicaid changes are part of a pattern of policies that look “fiscally responsible” on paper but are morally bankrupt in practice.
A Public Challenge: Evaluate This Policy Ethically
I call on Ohio lawmakers, Medicaid administrators, and members of the public — regardless of political affiliation — to honestly confront the question:
If a policy systematically removes access to care from people who are poor, disabled, or mentally ill, and they die as a result — how is that not a form of modern eugenics?
I urge journalists, legislators, and watchdog groups to:
- Investigate the real-world impacts of this policy on mental health and disability care.
- Demand transparency on how many clients will lose services.
- Hold accountable those who benefit politically or financially from the suffering of others.
