Catholic Health Association CEO: Funding cuts hurt access for vulnerable

When President Trump and lawmakers in Congress passed HR 1, a sweeping tax and spending package, Catholic hospitals delivered some of the most vocal protests about the impact of Medicaid cuts.

More than a year later, Sr. Mary Haddad, president and CEO of the Catholic Health Association of the United States, says she’s gravely worried about the prospect of more people losing coverage. The association represents about 650 Catholic hospitals and nearly 1,500 facilities providing long-term care and other services. About 1 in 7 hospital patients nationwide is treated in a Catholic hospital, the group says.

Haddad says the Medicaid cuts will have a broad impact, but they are going to be especially harmful to those with lower incomes. As regulations have come out, the impact looks to be even worse than expected, she says.

“These cuts in HR 1 smacked at the very heart of what we're about,” Haddad says.

“And so we continue to work with our members to see how they're trying to mitigate some of the impact, financial impact this is going to have, and how we'll continue to serve the people in the communities where we're present,” she continues. “I would say it's getting worse as we get closer to D-Day here, that we begin to feel the dramatic impact of the increase of uncompensated care.”

In an interview with Chief Healthcare Executive®, Haddad talks about the projected damage coming from cuts in Medicaid programs, the rise in uninsured patients Catholic hospitals are already seeing, and the financial toll on hospitals, including the prospect of reduced services.

‘This is getting worse’

Analysts project that Medicaid cuts from the HR 1 package (also dubbed the One Big Beautiful Bill Act) could amount to nearly $1 trillion over a 10-year span. Millions of Americans are expected to lose coverage, and states are also facing new restrictions in how they finance Medicaid programs.

While much of the funding cuts are still a few years away, there are some important changes in Medicaid programs taking effect in just a few months.

Starting on Jan. 1, 2027, new work requirements take effect for Medicaid beneficiaries. Most recipients must show they are working at least 80 hours per month to receive Medicaid benefits.

The Catholic Health Association says the work requirements could end up meaning some beneficiaries will lose coverage.

The group has long argued that healthcare is simply a basic human right. But Haddad says the regulations from the Centers for Medicare & Medicaid Services are especially troubling, because the rules could lead to some patients having to work even as they are dealing with serious illnesses.

“We see now what we call what they're calling functional assessment, where there will be another level of requirement where individuals will have to be able to demonstrate why their disability or whatever the category that deem them medically frail, why that hinders their ability to work,” Haddad says.

“So it's another layer of burden on the patient in order to demonstrate their state of health at this point in time, which I think is even more troublesome,” Haddad says. “So what we saw initially was bad. This is getting worse.”

Catholic hospitals are hearing from more Medicaid recipients who are concerned about potentially losing coverage, she says.

“It puts an undue burden on our physicians who are now the gatekeepers,” Haddad says. “They're the ones who are going to be accountable for ensuring whether or not this person is truly medically frail and whether or not they should receive Medicaid even though they're not able to work, and it skews the relationship between the patient and the physician.”

Medicaid beneficiaries will also face requirements to verify their eligibility more frequently, and Haddad says that could end up with some losing coverage. Medicaid recipients now must verify eligibility once a year, but starting in January, they will have to do it every six months.

“We're going to find that people are going to fall through the cracks because they're not going to keep up with what is going to be required in order to deem them eligible for Medicaid,” Haddad says.

“And I will tell you, this has historically been an issue, the paperwork that's required,” she continues. “And now to put additional requirements on them only exacerbates the issue, that there will be people that will end up falling through the cracks or no longer have eligibility just simply because they weren't able to complete the paperwork. So we've made it even more burdensome for people.”

Catholic hospitals are devoting more resources to help patients navigate new Medicaid requirements and helping those who are eligible maintain coverage.

“One of the things that we've seen is a redirection of staff to be available to help people walk through the process,” Haddad says. “But that being said, it redirects from patient care, over into these administrative requirements that are now necessary, which takes the focus off the patient and onto the paperwork, which I think is ludicrous.”

The toll on hospitals

Hospital leaders have warned that with reductions in Medicaid funding in the coming years, they will be weighing cuts in services, staff reductions and possibly the closure of facilities.

Haddad says Catholic hospitals may have no choice but to consider some reductions in services because of cuts in Medicaid. She says Catholic hospitals have about 1 million Medicaid discharges annually.

Even before the passage of HR 1, Haddad says, “They had already started to consider what will be the impact of these cuts, and certainly cuts in services.”

“We see where hospitals who are already critically underfunded are going to have to make decisions in order to continue to provide services as best they can,” Haddad says.

Haddad is careful to say that she doesn’t know of any Catholic hospitals that are likely to close, but she didn’t dismiss the possibility.

“There's nothing I would see coming down the pike right now, but not to say that won't be happening into the future,” Haddad says.

“Decisions are going to be made because we have finite resources,” she says. “And we're going to have to figure out the allocation of those resources in such a way that's going to be able to care for the patients as best we can. And it's going to be challenging.”

Haddad says the cuts are being done to control costs, but they’re placing more burdens on those who need support the most.

“We're making these cuts on the backs of Medicaid patients, and so access to care is going to be compromised,” she says. “We're not going to be able to provide the care and the access that we have been able to do in the past because we have limited resources.”

More uninsured patients

Catholic hospitals are already seeing an uptick in patients without coverage, due to the expiration of subsidies supporting the Affordable Care Act. With the loss of subsidies, premiums soared and many Americans dropped coverage.

As of Feb. 2026, there were 2.6 million fewer Americans with coverage under the Affordable Care Act than the previous year, according to an Associated Press analysis.

With the subsidies gone, Catholic hospitals are “seeing that impact,” Haddad says.

“Those who are choosing not to pay the exorbitant cost for insurance just simply because they have limited resources and they're making other choices, and these individuals are taking the risk that they're not going to get sick or they're not going to need healthcare,” Haddad says. “So we have seen an increase in uncompensated care.”

With the expectation of more people losing Medicaid coverage and those already unable or unwilling to pay higher fees for ACA plans, Haddad expects to see more uninsured patients.

“These folks still get sick, and they're going to be using the most expensive access to care, which is the emergency room, in order to get assistance, instead of having access to primary care on a regular basis,” Haddad says.

‘Unintended consequences’

Between reduced aid and greater requirements for Medicaid coverage, Haddad says there are “barriers to care for more people.”

Moreover, Haddad says she’s dismayed that lawmakers and the administration have made decisions with major implications on healthcare policy without considering the full implications on those who are affected.

Haddad says that’s what’s most troublesome for her.

She recalls working with fellow sisters years ago, with meetings in a chapel. The chapel had a message on the wall asking how decisions will impact the poor and vulnerable.

The message has stuck with her, especially as she thinks about new rules on Medicaid eligibility.

“I think we're making decisions without any regard at all for the impact it's going to have on the person,” Haddad says. “And so when we talk about our care and being patient-centered, I think we have to look at the federal government and what we're doing, in terms of these decisions that are meant to be beneficial for the people in this country, but truly, the unintended consequences, because of those decisions and those policies, will have on people who are poor and vulnerable.”

“If we were only able to bring that lens to bear, what good that could bring,” she says.