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As states and health systems prepare for sweeping changes to Medicaid under legislation that passed last year, including new mandatory “community engagement” (work, education, training and related activities) for many adults outlined in H.R. 1, Catholic health care leaders have a distinctive lens to bring to implementation: the moral vision articulated in Pope Leo XIV’s 2025 apostolic exhortation Dilexi Te (I Have Loved You).

In the summer and fall of 2025, the Center for Applied Research in the Apostolate (CARA) conducted a survey of those working in professional spiritual care within Catholic health ministries in the United States.

On Nov. 12, 2025, the seventh edition of the Ethical and Religious Directives for Catholic Health Care Services (ERDs) was officially released by the United States Conference of Catholic Bishops (USCCB) in Baltimore. For those of us working in the Catholic health care ministry, this was big news with significant implications for our work.

Fr. Nelson Baker was an ordinary man who did extraordinary things. His 60 years in the priesthood were spent sheltering the homeless, feeding the hungry, caring for the sick and giving hope to the destitute.

Like many of you, the events of the recent season have left me feeling powerless. Angst over recent policies persists, as some legislators attempt to oppress health care coverage for those most in need. We find ourselves asking, "How might I be an effective agent for change?" The divisiveness feels hopeless, where societal fear of the "other" looms as acceptable. As we look for God's unity amid the animosity, we ask, "How am I to be a bringer of peace?" But beneath powerlessness and hopelessness, soul questions lie dormant until their proper time.

Senior leadership formation programs have become fixed features of Catholic health ministries in the United States. They have such importance that every ministry has a means of providing them for their senior leadership, and the data indicate the establishment of a shared vision for content, process and programmatic experience.

Catholic health institutions in every corner of the world serve as beacons of hope, compassion and healing. From urban hospitals to remote rural clinics, the healing ministry continues to respond to the needs of communities with special attention to the most vulnerable.

While many in Catholic health care are familiar with our Catholic social teaching and the ways it is embedded in the care that we provide, these Catholic social teachings are also the central tenets of our community benefit programs and activities.

A 60-year-old woman living with chronic conditions such as asthma, polymyositis, rheumatoid arthritis and depression sought emergency care due to worsening shortness of breath. Following her discharge from the emergency department, she continued to struggle with her symptoms while also navigating significant barriers to recovery, including food insecurity, lack of transportation and the need for home-based medical support.

Formation is widely recognized as a crucial tool for embedding Catholic identity and essential for aligning personal values with Catholic health care's mission," writes Shaikat Sen, executive vice president of HSM Group and lead researcher for CHA's nationwide study of ministry formation across its membership. Launched in the fall of 2024 to build on findings from CHA's 2022 Mission Leader Survey, the survey's goal was to discover members' activities and needs related to ministry formation.

Health care in America is in need of a transformation. Average costs of care are consistently double those of other developed countries, while outcomes in the U.S. — like life expectancy, infant mortality and chronic disease management — fall short. Access remains a consistent issue with almost 8% of Americans, or 26 million people, without health insurance. Millions more are underinsured, causing them to delay or avoid care altogether.

At Catholic Health, we stand at a pivotal moment, charged with leading with clinical excellence and a sacred purpose rooted in the healing ministry of Jesus Christ.