All of this makes it especially difficult for organizations and communities that hope to open new health care facilities or reopen ones that have closed, like the Crozer Health hospitals in Delaware County, the last of which shuttered in May 2025.
“We desperately need to increase our health care capacity, and all of our efforts on that front are threatened by making the reimbursement landscape more challenging,” said Dr. Max Cooper, who was an emergency physician at Crozer-Chester Medical Center. “It’s harder to reopen a hospital when the hospitals are looking to invest all of this money into something that’s going to be entirely nonviable financially.”
Other health systems in the region have scaled back services or closed individual units and departments, with many citing existing and anticipated financial challenges.
The changes and Medicaid cuts will put already “broken” health care systems and emergency rooms “under enormous strain,” said Maureen May, PASNAP president and registered nurse at Temple University Hospital.
“People show up sicker,” May said. “They’ll show up to the ER, they’ll show up to the hospital, they’ll show up to care much later, and there will be fewer resources to help them. We know people will die due to the lack of access to care.”
Union members and advocates at the Thursday forum introduced a “Healthcare Bill of Rights” and are asking local and federal legislators to pledge support for programs like Medicaid and Medicare, a federal insurance program for people 65 and older.
The document also calls for the restoration of federal health subsidies for people who buy insurance on Affordable Care Act marketplaces. Enhanced premium tax credits that helped people reduce their monthly payments officially expired on Jan. 1.
In Pennsylvania, out-of-pocket premium costs have doubled, on average, according to state officials, which has caused some enrollees to switch to less comprehensive plans or drop coverage altogether.
Hospitals and health systems anticipate that they will see an increase in the number of uninsured patients as a result.
“The increase on those premiums, if you want quality insurance, it’s ridiculous,” said Latonta Godboldt, an in-home child care provider and business owner in Philadelphia who gets insurance through Pennsylvania’s ACA marketplace. “I was forced between choosing, ‘Am I going to pay the health insurance? The car insurance? A dance activity?’ Where am I going to make up these gaps?”