Leaders from some of the nation’s largest Catholic health systems — CommonSpirit Health, SSM Health, Avera Health, Christus Health and Covenant Health — are uniting in opposition to Senate Republicans’ proposed Medicaid cuts, warning that the legislation would deepen financial instability for hospitals, restrict access to essential services and endanger care for millions of Americans.
Collectively, these systems operate hundreds of hospitals and clinics across rural, suburban and urban areas — delivering care to tens of millions of patients annually, including millions enrolled in Medicaid. During a June 17 media briefing hosted by the Catholic Health Association of the United States, executives described the Senate Finance Committee’s budget draft as more aggressive — and potentially more damaging — than the House version passed in May.
CHA: ‘Champion policies rooted in compassion and dignity’
Sister Mary Haddad, president and CEO of the Catholic Health Association of the United States, called the Senate proposal “unconscionable” in its scope, pointing to proposed limits on provider taxes, state payments, and retroactive coverage, along with expanded work requirements and reduced support for immigrant populations.
“Based on our preliminary review, [the bill] would impose even more restrictions on provider taxes, state payments, work requirements and care for immigrants,” Ms. Haddad said. “These changes place additional burdens on many of the Medicaid patients we treat, while also limiting states’ ability to finance their programs.”
The CHA estimates the legislation could cause more than 10 million people to lose coverage and criticized the bill’s failure to extend ACA premium tax credits set to expire in 2025.
“These harmful proposals threaten the health and stability of the very communities we’re called to serve,” Ms. Haddad said. “We urge lawmakers to champion policies rooted in compassion and dignity.”
CommonSpirit: ‘A perfect storm of negative impacts’
Wright Lassiter III, CEO of Chicago-based CommonSpirit Health, warned that the cuts would cripple the financial progress hospitals and health systems have made in recovering from the COVID-19 pandemic.
CommonSpirit reported a $581 million operating loss (-1.5% margin) in fiscal year 2024, an improvement from the $1.3 billion loss (-3.6% margin) it recorded in 2023. While the system has made progress in its financial turnaround, it continued to post negative operating margins in the first two quarters of fiscal 2025.
“The proposed cuts that are on the table today will impact that progress and create a perfect storm of negative impacts: fragile financial status, more aggressive commercial insurers denying reimbursement for care, and now massive Medicaid funding cuts,” Mr. Lassiter said. “It adds up to individuals not being able to get the care that they desperately need, and putting the healthcare ecosystem at significant further risk.”
CommonSpirit, which operates 157 hospitals and more than 2,500 care sites in 24 states, delivers care through nearly 6.5 million Medicaid encounters each year. Fifty-six percent of the babies delivered across the system are covered by Medicaid.
Mr. Lassiter warned that the bill could jeopardize care at CommonSpirit’s critical access hospitals, many of which have operated with sustained negative margins for years and serve disproportionately high numbers of Medicaid patients.
“The fiscal impact to our critical access hospitals from the proposed bill will make it difficult to maintain access, and could result in closures in these communities,” Mr. Lassiter said. “The hospital is usually the largest employer, offering well-paying jobs. When those hospitals close, the entire community is impacted economically.”
He expressed concern that the plan could result in millions losing coverage, intensifying financial pressures on hospitals and forcing difficult decisions about services and staffing — all while pushing the most vulnerable populations deeper into crisis.
“Medicaid cuts won’t just harm those who really rely on it,” he said. “Those consequences will ripple across the entire healthcare system and hospitals and providers in our system and outside our system will be forced to make difficult decisions that will result in services not being available, not just for Medicaid patients, but for all patients. I’m hopeful that we’ll stand together to protect Medicaid, because fairness, compassion and shared prosperity aren’t just ideals, they’re values that define us as a nation.”
SSM Health: ‘It’s about people, dignity and the health of our communities’
Laura Kaiser, President and CEO of SSM Health, emphasized the human stakes behind the legislation by sharing the story of “Annie,” a Medicaid patient who overcame major barriers to stability through consistent care.
“She had Medicaid coverage, but no job, no transportation and few resources. We provided her with some transportation services to and from her appointments, and over time, with consistent care and counseling, Annie began to find her footing,” Ms. Kaiser said. “Today, four years later, Annie is working full time, has bridged from Medicaid coverage to commercial insurance, has a driver’s license, a car and a home of her own. That’s what access to high quality, compassionate healthcare looks like, and makes possible.”
SSM Health serves patients in Illinois, Missouri, Oklahoma, and Wisconsin, where more than 63% of those served are covered by Medicare or Medicaid. Another 5% are uninsured. Ms. Kaiser highlighted the outsized impact the cuts would have on rural communities, where Medicaid is often the primary payer.
Ms. Kaiser also emphasized that rural hospitals — often the only option for care — would be hardest hit.
“Our rural hospitals … are facing enormous challenges — staffing shortages, rising costs, and in many cases, razor thin margins or no margin. For many, Medicaid is the primary payer,” Ms. Kaiser said. “When that support is weakened, the entire system teeters. When rural hospitals close, entire communities lose lifelines — not just for chronic care, but for emergencies, childbirth, trauma and everything in between.”
She also noted that states need flexibility in how they fund Medicaid programs. For example, Missouri has one of the highest provider taxes in the country, while Wisconsin, a self-funded state, would face new limitations under the Senate plan.
“This is more than being about budgets and policy,” she said. “It’s about people, dignity and the health of our communities. We urge Congress to reject these cuts. Please work with us … to strengthen our nation’s health system, not further weaken it.”
Christus Health: ‘These are real people and real consequences’
Gabriela Saenz, Senior Vice President at Christus Health, which serves communities across Texas, Louisiana and New Mexico, said more than 60% of the system’s patients rely on government programs such as Medicaid.
“We are sounding the alarm because this really would be devastating to the people that we serve,” Ms. Saenz said. “We estimate 150,000 [patients] will be losing Medicaid coverage in areas and towns like Texarkana and Tyler, Texas. When you look at those two populations alone, 150,000 is the makeup of those two together — that is devastating to the care and the communities that otherwise would not have that care.”
Ms. Saenz warned that the $4.3 billion in state-directed payments at risk under the proposal would devastate the infrastructure that enables Christus to serve vulnerable communities. Innovative, non-reimbursed programs — such as rural nurse practitioner outreach efforts — would also be endangered.
“These are real people and real consequences,” she said.
Avera Health: ‘A pivotal moment in rural healthcare’
Shantel Krebs, regional president and CEO of Avera St. Mary’s Hospital in Pierre, S.D., said the legislation would be especially harmful for rural and Indigenous populations across Avera’s 72,000-square-mile footprint.
“Avera has 270 hospitals, clinics and nursing homes [combined] … and over 22,000 employees. Rural health care is truly in our DNA,” Ms. Krebs said. “[These funding cuts] could impact communities by closing emergency rooms, maternity care, behavioral health services, or even having access at all.”
In Central South Dakota, many of Avera’s patients — including American Indian women — already drive hours for obstetrics care, and many in South Dakota are driving an hour or two just to even have access to care, according to Ms. Krebs.
Ms. Krebs noted that Medicaid supports more than 50% of residents in Avera’s long-term care facilities, and that the proposed cuts would make it even harder to pay staff or maintain care access.
“We are truly at a pivotal moment in rural healthcare.”
Covenant Health: ‘This is the wrong discussion for us to be having’
Bradford Coffey, senior vice president of Covenant Health and president of the Covenant Health Foundation, underscored the ethical and personal dimensions of the legislation’s impact.
Covenant Health operates hospitals in Maine and New Hampshire, along with care sites in Massachusetts, Rhode Island, and Pennsylvania. With Maine and New Hampshire home to the nation’s oldest populations, demand for care is high and provider shortages are severe.
“Maine and New Hampshire have really been struggling with shortages of providers and nurses. We have a true problem with our demographic. We just don’t have enough young people to care for the aging seniors as well as the rest of us,” Mr. Coffey said. “Medicaid is not nearly enough to cover our costs, pay our staff and invest in the health of our communities. The proposed cuts would be devastating to our hospitals and the 204,721 people we serve.”
He said Medicaid enrollment is projected to fall by 14% in both Maine and New Hampshire. Across Covenant Health’s three hospitals, 34,922 patients rely on Medicaid, and the cuts would strip coverage from nearly 4,900 of them, reducing system funding by $12.7 million.
“I realize those numbers are small compared to some of the numbers that have been thrown around, but just remember, every one of those is a person, a mother, a daughter, someone who’s important to someone else,” he said.
Mr. Coffey reinforced that the cuts will lead to more patients putting off necessary care, increasingly overburdened emergency departments, and a staff stretched thin without the resources to maintain programs like 24/7 domestic violence care.
“Those on Medicaid are the poor, and we have a moral duty to care for them,” he said. “We should not be talking about cuts to Medicaid. We should instead be talking about adding funding to Medicaid and reforming how we promote healthcare in this country; this is the wrong discussion for us to be having.”
As the July 4 legislative deadline approaches, these Catholic health system leaders urged Congress to reject the Senate proposal and protect the health of vulnerable communities.
