In September, the nation reached a major milestone when the Treasury Department announced that 50 million Americans have received healthcare coverage through the Affordable Care Act since it took effect in 2014. The Catholic Health Association of the United States is proud to have been a consistent advocate for protecting and strengthening America’s health safety net as part of our mission to provide quality care for the most vulnerable.

Public policy that supports a robust safety net is critical in partnership with mission-driven service in underserved and vulnerable communities. As Congress approaches the year-end appropriations debate — elected leaders in Washington must prioritize the extension of critical health and family safety net programs to ensure continued access to affordable and quality care for all.

That is why CHA is advocating for a critical extension of the enhanced premium tax credits (PTCs) that help millions of Americans access healthcare coverage before they expire next year. If Congress fails to make the PTCs permanent — or, at the very least, extend them by a year — 4 million Americans are expected to lose coverage entirely, creating a cascade of negative implications across the healthcare system. Moreover, those individuals and small businesses participating in the insurance marketplace will face considerable price increases as issuers begin finalizing new rates in early 2025, as patients save an average of $700 a year due to the enhanced PTCs.

As part of our commitment to strengthening our nation’s health safety net, we also urge Congress to reject cuts and structural changes to Medicaid funding that would cause millions of individuals, families and children to lose coverage.

Recent eligibility changes and the process of states unwinding Medicaid have already resulted in more than 25 million people being disenrolled as of September, leaving many Americans uninsured.

Catholic health systems have been proactive in addressing this loss of coverage by providing educational resources to help ensure eligible low-income individuals and families can retain coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Trinity Health, which serves 30 million patients across 26 states, sent more than 200,000 letters informing patients about the Medicaid redetermination rules and provided active financial counseling to help patients understand their health insurance options on a state-by-state basis in light of new eligibility criteria.

With millions of Americans’ coverage through Medicaid hanging in the balance, Congress must address the Medicaid disproportionate share of hospital cuts that will go into effect on January 1, reducing support for hospitals that serve a high number of Medicaid and uninsured patients by $8 billion. With Catholic hospitals reporting nearly 1 million Medicaid discharges annually out of almost 4.5 million admissions, our systems have served as a lifeline for economically disadvantaged patients in underserved areas. Such cuts would be devastating at a time when hospitals serving low-income and rural populations are already shouldering the costs associated with the loss of Medicaid coverage during the post-COVID redeterminations process.

Congress also has an important opportunity to rectify an onerous new nurse staffing mandate for long-term care facilities issued this year by the Centers for Medicare and Medicaid Services. While we support adequate nurse staffing to ensure the well-being of nursing home residents, the new rule is unworkable and could harm residents and nursing facilities, potentially forcing facilities to close if there are not enough nurses to meet the mandate. Congress should include legislation preventing CMS from enforcing this rule, as it will exacerbate issues created by insufficient reimbursement and the national healthcare workforce shortage, leaving some of our most vulnerable seniors without the compassionate and attentive care they need.

Since their foundation in the 19th century, Catholic healthcare institutions have been focused on carrying out their mission to provide accessible, high-quality and compassionate healthcare, regardless of patients’ ability to pay. For decades, Catholic healthcare has established a high standard when it comes to caring for people with the greatest need — whether it be in our facilities or in neighborhoods.

To ensure we can maintain and exceed that high standard — and continue providing high-quality, affordable and accessible healthcare services — we need Congress to do its part to keep the critical safety net that allows us to continue our mission-driven work to serve those with the greatest need.

Sister Mary Haddad is president and CEO of the Catholic Health Association of the United States. She wrote this for InsideSources.com.