Leaders of member health care networks of the Catholic Health Association convened for a press briefing ahead of lobbying efforts in Washington on May 20. The anxiety among the group was palpable as they described significant ripple effects that are likely to follow funding reductions and new eligibility requirements proposed by the Trump administration for Medicaid and the Affordable Care Act Marketplace.
The hospital chiefs pointed out that Catholic networks were already significantly subsidizing what they described as insufficient Medicaid reimbursements while also covering payments for millions of uninsured patients they treated. They argued that the proposed cuts in Medicaid will mean cost shifts that will reduce care for all Americans and drive insurance premiums and medical costs higher for customers able to pay through the private market.
The health care executives warned that low-income urban and isolated rural communities would be hardest hit.
Mary Haddad, R.S.M., the president and chief executive of C.H.A., said, “These proposed changes threaten access to care for millions of Americans, particularly those in underserved areas, where our member systems work every day to provide quality, compassionate care.”
New cost-cutting provisions, she said, “could result in coverage losses for millions of people, creating new administrative barriers for families, providers and states instead of strengthening our health care system.”
“Congress has a moral obligation to consider the real and harmful consequences these proposals would have on our nation’s health care safety net and the impact on the lives of America’s most vulnerable individuals,” Sister Haddad said. ”Medicaid is not just a health program. It’s a lifeline.”
The Trump administration and House Republicans are pressing for large-scale reductions in Medicaid in pursuit of billions in federal savings over the next decade in a budget reconciliation package they hope to pass this week, the “one big beautiful bill.” The bill would make 2017 tax cuts permanent and seeks more than $625 billion in Medicaid savings over 10 years.
Those savings will be created by new work requirements, raising barriers to enrollment and renewal in Medicaid coverage, and limiting states’ ability to raise the state share of Medicaid revenues through provider taxes. According to an analysis from K.F.F., states will be forced to make tough choices: “maintain current spending on Medicaid by raising taxes or reducing spending on other programs; or cut Medicaid spending by covering fewer people, offering fewer benefits, or paying providers less.”
C.H.A. leaders said that the administration’s effort to save money on health care is doomed to backfire considering the potential long-term additions to health spending that would result from reductions now. The Congressional Budget Office projects that 8.6 million people would lose access to health insurance over the next decade as a result of the administration’s plan.
“We are at an inflection point in the provision of health care to this country, not just for the vulnerable,” Eric Wexler, the president and C.E.O. of Providence, said. He said the nation was facing “a polycrisis,” confronted simultaneously by inflation, labor shortages and tariffs, “but most impactfully [by] what is being proposed in Congress right now to cut Medicaid.”
He pointed out that 50 percent of the infants born in the United States are covered by Medicaid, adding that 30 percent of the patients seen by Providence are on Medicaid. “And when Medicaid suffers,” Mr. Wexler said, “the entire country suffers because people that are dependent on having access for preventative care need this type of coverage, so they don’t get sicker and wind up in our emergency departments and in our I.C.U.s.”
“For a potential short-term gain,” he said, “we will have long-term pain.”
Eduardo Conrado, the president of Ascension, said that 20 percent of the network’s patients are covered by Medicaid or are uninsured. He said that C.H.A. member institutions “cover nearly 34 percent of the cost for Medicaid patients” and absorb “88 percent of the cost to deliver care” to under- and uninsured patients. Those numbers depict provider networks, the C.H.A. leaders said, that are already in no position to begin absorbing additional costs because of government reductions in health spending.
“Let me be clear, Ascension supports the effort to remove fraud, waste and abuse in public programs, but this proposal does not do that. Instead, it creates unnecessary red tape, which causes eligible people to lose coverage because of paperwork problems and system errors.
“Medicaid is not a handout,” he said. “It’s a safety net. It ensures that children, seniors, low-income families and people with disabilities get basic health care. These are not just policy issues, they're personal; it involves people—our neighbors.”
Mike Slubowski, the president and chief executive of Trinity Health, predicted “economic chaos” ahead as large employers resist paying higher health insurance costs as providers seek to cost-shift to make up for Medicaid shortfalls. “Employers will not accept additional burdens for a government responsibility,” he said.
Mr. Slubowski also discounted claims about “able-bodied adults” taking advantage of Medicaid, frequently held up by the system’s critics to justify stronger work requirements. “Our trained financial counselors help patients every day who are eligible to obtain Medicaid coverage under strict state and federal guidelines, and we can say with confidence that we do not see the waste, fraud and abuse of the program that’s been stated,” he said.
“We also know from experience that states that have attempted to impose work requirements have spent more managing that initiative than they have spent providing Medicaid coverage to those who need it.”
According to Mr. Slubowski, “while not perfect, Medicaid’s medical and social safety net [represents] a fundamental responsibility of government to serve communities.” He expressed the hope that a bipartisan effort could be established to protect Medicaid, pointing out that significant numbers of Medicaid recipients can be found in every congressional district in the country.
Medicaid, Sister Haddad said, “provides access to care for those in our nation who need it most: poor and vulnerable children, pregnant women, the elderly, adults and disabled individuals, while ensuring their dignity.”
“We urge Congress to reconsider these proposals,” she said, “and instead, champion policies rooted in compassion and dignity by ensuring everyone has access to affordable health care coverage. By protecting our most vulnerable, we create a healthier, stronger society for everyone.”
