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It's vital that lawmakers recognize how crucial Medicaid is for providing affordable, quality care, says this health system CEO.

Editor's note: Damond Boatwright, MHA, MHS, FACHE, is president and CEO of Hospital Sisters Health System, a nonprofit system based in Springfield, Illinois.

Attention across the nation is rightly focused on potential massive and drastic Medicaid cuts under consideration by Congress that would imperil healthcare for nearly 80 million of our most vulnerable neighbors—low-income families, expectant moms, children and senior citizens, as well as individuals with disabilities.

Rural hospitals caring for communities in America’s heartland, which are already struggling, will be further devastated by these cuts, making access to quality healthcare another unobtainable element of the American Dream.

The 13 hospitals that make up Hospital Sisters Health System serve small communities throughout Central and Southern Illinois, and Northeastern Wisconsin. The populations in these towns often reflect higher reliance on Medicaid, especially among children. According to the McCourt School of Public Policy at Georgetown University, 25% of children in Macon County, Illinois, home to HSHS St. Mary’s Hospital, rely on Medicaid. In Brown County, Wisconsin, home to HSHS St. Mary’s Hospital Medical Center and St. Vincent Hospital in Green Bay, nearly 32% of children rely on Medicaid.

As representatives of nonprofit, Catholic healthcare, HSHS views healthcare as a basic right.

For us, healthcare service is more than an occupation—it is a vocation. We treat every patient with the same love and compassion St. Francis showed to lepers banished to live outside medieval city walls.

Medicaid, along with Medicare, was created in that same spirit in 1965, with President Lyndon B. Johnson noting the new health insurance program jointly funded by the federal and state governments reflected an American tradition, directing us: “never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.”

Who among us has not been vulnerable at some point in their life, or knows a relative, friend or neighbor who has? Public opinion polls bear out this sentiment, with the nonprofit health policy research group Kaiser Family Foundation (KFF) reporting that two-thirds of U.S. adults have some connection to Medicaid. Additionally, more than three-fourths hold a favorable view of the program.

The human toll of these cuts would be unconscionable and the economic impact devastating. KFF estimates state governments could shoulder additional Medicaid costs of $1 trillion over the next decade if the federal government caps its contribution per enrollee and withdraws its 90% match to states that expanded Medicaid under the Affordable Care Act.

We support the dignity of work, yet potential work requirements for Medicaid participants appear counterproductive, since KFF research shows nearly two-thirds of Medicaid adults are already working, usually at low-paying jobs that either don’t offer insurance or do so at unaffordable rates.

The overall result of these proposed changes: States would be forced to dramatically scale back their Medicaid programs, hurting enrollees and impacting practically every hospital across the country, including those HSHS operates. Medicaid accounts for 24% of inpatient admissions in Illinois hospitals, according to the Illinois Health and Hospital Association, while the program makes up 14.5% of total gross patient revenue in Wisconsin hospitals, according to the Wisconsin Hospital Association.

Hospitals across the U.S. are still grappling with COVID-19 fallout, facing workforce shortages and shrunken margins. As a nonprofit system, HSHS is not profit driven. Yet we must operate on some measure of solid financial footing to carry out the legacy of our founding and current Hospital Sisters.

Our Sisters founded four of our Illinois hospitals 150 years ago this year and within days of their arrival from Germany were knocking on doors, seeking donations. We keep that drumbeat alive today, but we cannot continue our mission on contributions alone.

We urge Congress to maintain federal funding commitments for the Medicaid program to prevent structural changes that would rob coverage from those in need. Our federal lawmakers must remember their mission in representing all constituents for the common good.

Editor's note: Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content.

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