Just two miles north of the U.S.-Mexico border, the 25-bed Holy Cross Hospital in Nogales, Ariz., serves as a primary safety net for residents in the County of Santa Cruz. The staff serves a population that is more than 80 percent Hispanic, according to the U.S. Census, and has a median household income of about $43,000.
The Catholic hospital, part of the Carondelet Health Network, cares for a city with a 20 percent poverty rate. In a typical year, this mission-driven hospital provides millions in uncompensated care for the uninsured or those whose treatments are not covered by Medicaid. For many families in the county, Holy Cross is the only option, which is why it is designated as a Critical Access Hospital. The next closest hospital is St. Mary’s in Tucson, about 70 miles away.
Holy Cross is one of an estimated 380 independent rural hospitals that are at serious risk of closing in 2026 because of the One Big Beautiful Bill Act, passed by Congress last July. These hospitals, often the sole sanctuary in vast health care deserts, are expected to lose 56 percent of their funding because of the bill. The measure requires able-bodied adults between the ages of 19 and 64 to perform and document at least 80 hours of work, community service or job training per month to be eligible for Medicaid coverage.
The Congressional Budget Office estimates that the change could lead to millions losing insured care because of the complex paperwork it entails—as many as 10.5 million by 2034. The legislation also placed caps on supplemental funds that states had previously used to support hospitals that served underprivileged communities.
The Trump administration is turning away from this social responsibility, instead taking a more consumerist, individualist approach. “By prioritizing recovery, nutrition, physical fitness and personal empowerment, providers across this state are driving a shift from a reactive sick-care system to a true health care system that delivers better outcomes for the American people,” Secretary Robert F. Kennedy Jr. of the Department of Health and Human Services said while visiting Arizona in April.
Some of the values and concerns expressed by the Make America Healthy Again movement resonate with Catholic social teaching, including infrastructure that supports sustainable agriculture and healthy living in communities through improved access to nutritious foods and facilities for recreation and exercise. Toxins in food and agricultural run-off endanger all Americans, including those on what Pope Francis called the “peripheries.” Environmental degradation, Pope Francis wrote in “Laudato Si’,” most immediately harms the poor (No. 20).
Yet the near exclusive emphasis on factors like nutrition and physical fitness can also demonstrate an ignorance of the lives of those on the margins, whether in rural or urban areas. Too often, those living in poverty also inhabit food deserts, lacking access to supermarkets and affordable nutritious food. These areas often also lack public parks or other facilities conducive to healthy exercise, indoors or out.
Of further concern is Mr. Kennedy’s vaccine skepticism, which downplays how they have benefited people around the world. As secretary of the department he has, for example, described the choice to vaccinate children a “personal one,” revised the immunization schedule and promoted Vitamin A to defend against illness in place of vaccines. Last year, a measles outbreak infected more than 1,000 South Carolina residents, over 90 percent of whom were unvaccinated children. Rather than representing a solely “personal” choice, the loss of herd immunity to measles presents life-threatening risk to others, especially to those who cannot make the choice to be vaccinated, like children under 6 months old.
“Health cannot be a luxury for the few,” Pope Leo XIV said during a conference at the Vatican in March. He described health care as “an essential condition for social peace,” adding that universal health coverage is essential when forming just societies.
The most vulnerable among us will receive the care they need only when proper attention is paid to the structures that administer health care. It is senseless for policymakers to insist on ridding home pantries of toxins while at the same time cutting the safety nets that serve the poor among us.
Catholic social teaching is built on the common good and the dignity of the human person. The recognition of this dignity is the basis of the church’s teaching against abortion, contraception, sterilization, in vitro fertilization and euthanasia. It also leads the church to recognize that access to adequate health care is a human right.
The church has also recognized the preferential option for the poor, giving a modern name to God’s special care for marginalized people—the widow, the orphan, the stranger in the land—testified to throughout Scripture. As the Peruvian theologian Gustavo Gutiérrez explained, this preferential option is grounded in God’s gratuitous love for humanity, a love that we have not and cannot earn. Those who live in unjust circumstances are especially beloved by God because of their need, not because they have documented 80 hours of work.
The moral necessity to care for the poor and marginalized can be found not only in Catholic teaching but also in the history of the United States. Almshouses, like a Philadelphia charity hospital founded in 1732, cared for those who could not be cared for at home. The founders of the United States also made the health of the vulnerable a priority in measures like the Act for Relief of Sick and Disabled Seamen, which President John Adams signed into law in 1798. The act established a federal network of hospitals that cared for those who served a key role in the economy of the budding nation. More than 100 years later, after a civil war and the arrival of immigrants at Ellis Island, the act evolved into the U.S. Public Health Service.
The founders understood what many Americans seem to have forgotten: A nation is only as healthy as its most vulnerable. In 2026, as in 1798, the most vulnerable certainly include the elderly and those with special needs. But they also include those who have become the nation’s essential laborers: farm laborers working in the borderlands and the heartland who provide the nutrition that sustains the nation.
Removing the safety nets for the most vulnerable contradicts the American spirit that our nation celebrates in its 250th year. Rather, the American spirit of ambition and personal responsibility is both supported and deepened by the recognition that we should care for one another.
It also goes against the Gospel and against common sense to pretend that we are in complete control of our health or that bad health outcomes are simply the result of bad personal choices. Prioritizing health care for the most vulnerable among us recognizes not only that we were all created equal but also that we were created to care for each other, from sea to shining sea, from urban hospitals to rural ones.
This article appears in June 2026.
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