By Alan Condon
(Source: Becker’s Hospital Review)
As Senate Republicans advance proposals for deeper and broader Medicaid cuts than those already passed by the House, health system leaders — particularly in Catholic, mission-driven systems — are escalating their advocacy efforts behind the scenes in Washington, D.C.
During a June 17 media briefing, Catholic health system executives shared details about the conversations taking place on Capitol Hill and what signals they’re picking up as lawmakers push to move the “One Big Beautiful Bill Act” to President Donald Trump’s desk by July 4.
“There’s a really strong desire to not see our hospitals — already stressed — further stressed,” Bradford Coffey, senior vice president and president of Andover, Mass.-based Covenant Health Foundation, said in response to a question from Becker’s. “They’re committed to standing up and making sure that the pretty weak financial situation doesn’t become weaker.”
That sentiment, while reassuring, is tempered by political realities. One key area under discussion: Medicaid work requirements.
According to Mr. Coffey, there is clear interest among some lawmakers in attaching work requirements to Medicaid eligibility. However, he warned that implementation timelines and funding assumptions in the current legislation are out of step with reality.
“To implement a work requirement program in roughly 18 months, which is what the House bill calls for, just is not even close to being realistic,” he said.
The House bill proposes just $100 million in funding to help all 50 states establish work requirement systems — a figure hospital leaders say falls dramatically short of what’s needed. In practice, many worry that a rushed and underfunded rollout would result in eligible patients being disenrolled or facing bureaucratic barriers to care.
Behind closed doors, hospital leaders are advocating not only for outright opposition to harmful provisions, but also for mitigation strategies if work requirements remain in the final package. One such strategy: pushing back the implementation date, to give states and providers more time to prepare and protect vulnerable patients.
With the July 4 deadline approaching, hospital leaders remain engaged in urgent dialogue with federal lawmakers. While the path forward remains uncertain, Mr. Coffey and his peers continue to emphasize that further destabilizing the safety net would have far-reaching consequences — not just for hospitals, but for entire communities.
“We are hearing that there is some potential appetite for work requirements,” Mr. Coffey said. “But also some willingness to consider how to mitigate some of the harm, in terms of financial impact and the impact on people.”
As negotiations continue, health systems — particularly those serving low-income and medically complex populations — remain at the forefront, actively advocating against proposed Medicaid cuts and highlighting the potential impact on patient care.
