Action Center

Support Health Equity and Access to Affordable Health Care in the Build Back Better Act

Dear CHRISTUS Advocates:

CHRISTUS Health asks that you contact your Members of Congress to urge them to support policies that expand access to affordable health care, address health equity, strengthen the health care workforce and improve and enhance the social safety net in the pending budget reconciliation legislation, the Build Back Better Act (H.R. 5376). Hospitals have been on the front lines of providing care during this challenging time, and we have seen first-hand the impact of COVID-19 on the elderly, families and children, and low-income, minority and rural populations.  Our federal Representatives and Senators are in the process of considering major legislation that will help rebuild communities hit hard by the pandemic and provide our patients with tangible resources to improve their health and lives. 

The November 3rd version of the bill includes an extension of the increased Affordable Care Act (ACA) tax credits through 2025 and closes the Medicaid coverage gap in non-expansion states by providing premium tax credits through 2025 so certain individuals can access exchange plans with no premium. The bill also provides certainty for federal Medicaid matching funds through September 30, 2022. Home and community-based services will see a $150 billion investment and Medicare beneficiaries will gain access to a hearing benefit should the current iteration of the legislation pass.

It is critical, however, that you also relay to your Representatives and Senators that you do not support cuts that undermine the purpose of the coverage funding expansion. Sec. 30608 of the Build Back Better Act (H.R. 5376) would impose a 12.5% cut in Medicaid Disproportionate Share Hospital (DSH) payments to states that have not expanded Medicaid. Specifically, the 12 states that failed to expand their Medicaid program face reductions in Medicaid DSH payments and federal funding for uncompensated care pools.  

It is not certain that non-expansion states will actually expand Medicaid even with this penalty.  What IS clear is that such a significant cut to DSH payments will directly harm hospitals, like CHRISTUS, and the patients we serve in non-expansion states; the payment cuts are certain, but the coverage gains are not. 

Congress has an opportunity to pass legislation that will address health equity and health insurance affordability by allowing individuals and families to continue accessing affordable premium and out-of-pocket costs of health insurance coverage.  But further constraining hospital and health system resources with significant cuts to our DSH payments could gravely reduce our ability to continue serving our patient communities.

We encourage you to contact your Members of Congress and Senators and urge them:

  1. To support policies that address health equity and access to affordable health care, which are vital to our ability to continue providing care as we carry out our mission of extending the healing ministry of Jesus Christ; and
  2. To oppose the DSH policy that unnecessarily punishes hospitals and health systems and their communities and weakens a program that protects our neediest patients.

I appreciate all of your efforts to advance our CHRISTUS Health’s Catholic health ministry. 


Gabriela M. Saenz

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