Pope Leo XIV Calls for Universal Healthcare as 4 Million Americans Lose Coverage

The first American pope called healthcare a “moral imperative” at the Vatican — while back home, ACA subsidies have expired and millions are going without.

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On Wednesday, March 18, Pope Leo XIV stood before a private Vatican audience of European bishops and World Health Organization officials and delivered a message that should discomfit every lawmaker in Washington:

“Universal health coverage is not merely a technical goal; it is primarily a moral imperative.”

The address — given at a conference titled “Today who is my neighbour?” organized by the Council of the Bishops’ Conferences of Europe, the WHO’s European Region, and the Italian Episcopal Conference — marked at least the third time in his young pontificate that Leo has placed healthcare squarely at the center of his moral agenda.

And this time, the pope went further, warning that when the sick and the poor cannot access medicine, the result is social rupture. “Health cannot be a luxury for the few,” Leo told the assembly. He called it “an essential condition for social peace.”

The timing is auspicious.

Back home in the United States — the only major industrialized nation without universal health coverage, and the pope’s homeland — enhanced Affordable Care Act premium subsidies expired on December 31. The consequences have been brutal. Premiums for marketplace enrollees have spiked an average of 114 percent.

An estimated 4 million Americans are projected to lose coverage entirely because they simply cannot afford it. Congressional Republicans, with the quiet acquiescence of the White House, allowed those subsidies to lapse without so much as a floor vote on renewal.

The U.S. bishops saw this coming.

The USCCB urged Congress last fall to extend the tax credits, arguing that affordable coverage is integral to the Church’s consistent ethic of life. Their pleas were ignored. Millions of working families — disproportionately in rural and Southern communities where Catholic parishes anchor civic life — are now choosing between groceries and prescriptions.

A Pope Shaped by Pandemic

Leo’s insistence on healthcare as a right is rooted in biography, not abstraction. As Bishop Robert Prevost of Chiclayo, Peru, he lived through the worst of COVID-19 in a region with a collapsing health infrastructure.

He launched the “Oxygen of Hope” campaign to rush oxygen supplies to overwhelmed hospitals. He buried parishioners who died because ventilators never arrived. Before that, he shepherded his diocese through catastrophic flooding and a dengue fever outbreak. The man who now leads the Catholic Church learned what healthcare deprivation looks like — measured in body bags, not policy papers.

That experience has produced a pope who speaks about health with an authority that few world leaders can match. In February, addressing the Pontifical Academy for Life, Leo declared that “healthcare is not a consumer good but a universal right” and lamented “enormous inequalities” between nations and social classes. He called wars that destroy hospitals “the most grave attacks that human hands can make against life and public health.”

In his January “State of the World” address to the diplomatic corps, he denounced the destruction of medical infrastructure as a violation of international humanitarian law.

Wednesday’s address added a new dimension. Leo invoked the parable of the Good Samaritan — the foundational story of Christian obligation to the suffering stranger — and urged Christians to ensure their daily lives reflect what he called a “fraternal, ‘Samaritan’ spirit — one that is welcoming, courageous, committed and supportive.”

He also drew attention to rising youth mental health crises across Europe, a signal that his healthcare advocacy extends well beyond hospital beds and insurance premiums.

The American Disconnect

There is something almost surreal about the first American pope pleading with the world to treat healthcare as a moral imperative while his own country moves in the opposite direction.

The expiration of the ACA subsidies was not an accident of legislative timing. Republican leaders made a deliberate choice to let them die, calculating that the political cost of 4 million people losing coverage was lower than the cost of extending a program associated with Barack Obama. The cruelty is the arithmetic.

Catholic teaching offers no ambiguity on this point. The Catechism identifies concern for the health of citizens among the duties of public authority.

Pope John XXIII, in Pacem in Terris, listed medical care as a basic human right alongside food, clothing, and shelter. Benedict XVI reiterated this in 2010.

Pope Francis called access to healthcare “not a consumer good, but a universal right.”

Leo has now taken up that same banner with the force of personal witness — a man who ran an oxygen drive in rural Peru lecturing the world — particularly the richest nation on earth — about what it means to let people die for lack of insurance.

The U.S. bishops have been consistent on this. Catholic Charities and Catholic hospitals remain among the largest providers of healthcare to uninsured Americans. The institutional Church puts its money where its mouth is. What remains missing is political will — from the party that claims Catholic voters as its base while dismantling the safety net those voters depend on.

Leo’s message on Wednesday was aimed at European policymakers, but its sharpest edge cuts across the Atlantic. The first American pope is watching his countrymen lose their health coverage, and he is calling it what Catholic tradition has always called it: injustice.

At Letters from Leo, we stand with Pope Leo XIV and the millions of Americans — Catholic and otherwise — who believe that access to a doctor should never depend on the size of your bank account.

The U.S. bishops called on Congress to protect the vulnerable, and Congress turned its back. The pope is now making the same case to the world.

In an era where the powerful treat healthcare as a budget line to be slashed, we remain rooted in a faith that insists on the dignity of every person — born and unborn, insured and uninsured, in every emergency room and every parish food pantry in the country.

This is the fastest-growing Catholic community in the country because people are hungry for something deeper than cynicism dressed up as fiscal responsibility. They want leaders who will name injustice when they see it — and a pope who already has.

If you believe this movement matters — Catholics and people of goodwill demanding that America live up to its own founding promise of life and liberty — I am asking you to join us.

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