Healthcare at the Precipice: Sr. Mary Haddad on the Looming Coverage Crisis

As 2025 draws to a close, millions of Americans stand at the edge of a healthcare cliff. Sister Mary Haddad, President and CEO of the Catholic Health Association, returns to The Healthy Project to sound the alarm on an urgent policy crisis that threatens to undermine healthcare access for working families nationwide.

Following the passage of major Medicaid cuts in July that will affect 10 million people, enhanced premium tax credits under the Affordable Care Act are set to expire at the end of the year. The result? An estimated 4.2 million more Americans are losing coverage, with millions facing dramatic cost increases. For rural communities already struggling with limited resources, the impact could be devastating.

This episode examines the intersection of healthcare policy, economic justice, and human dignity. Sister Mary draws on Catholic social teaching to frame healthcare access not merely as a policy preference but as a moral imperative rooted in the inherent worth of every person. She offers a clear-eyed assessment of how hospital closures, emergency department overcrowding, and the loss of telehealth flexibilities create a perfect storm threatening the most vulnerable among us.

Beyond diagnosis, this conversation explores solutions. What must Congress do immediately? How can healthcare systems balance mission-driven care with financial sustainability? What role should everyday citizens play in advocacy? And perhaps most importantly: what does hope look like when systems are breaking down?

In This Episode:

The Immediate Crisis

• Understanding the connection between July's Medicaid cuts and expiring tax credits
• Why 4.2 million working Americans face losing coverage
• The "sticker shock" families are experiencing during open enrollment
• Congressional gridlock and the December deadline

Rural Healthcare Under Pressure

• Lower median incomes meeting higher insurance costs
• The competitive disadvantage of rural insurance markets
• Hospital closures and service reductions on the horizon
• The hidden costs: hotel stays and hours-long drives for basic care

Emergency Departments as Safety Net

• Why ERs become primary care when coverage disappears
• The economic burden of treating delayed, acute conditions
• Federal mandates and the impossible position of hospitals
• Triage challenges when systems are overwhelmed

The Telehealth Question

• How COVID revealed telehealth's essential role
• Temporary extensions vs. permanent policy solutions
• Access equity and the digital divide
• Real stories from rural South Dakota

Moral Framework & Advocacy

• Healthcare as inseparable from human dignity
• Operating as a "ministry that functions as a business"
• The responsibility of citizens to engage with the government
• Moving from despair to concrete action

Looking Forward

• Strengthening existing coverage systems
• The critical need for primary care investment
• Acknowledging that U.S. healthcare is "broken"
• Building coalitions across providers, payers, and government

Sister Mary's perspective is particularly vital for those interested in the social determinants of health, healthcare economics, policy advocacy, and faith-based approaches to social justice. Her framing of hope as "concrete actions" rather than abstract aspiration offers a powerful counter-narrative to policy fatalism.

Guest: Sister Mary Haddad, RSM, President & CEO, Catholic Health Association of the United States

Resources: Learn more and take action: www.chausa.org

Show Notes