Even as many Republican-ruled states push for sweeping abortion bans, some Democratic-ruled states are increasingly concerned that reproductive health care options are shrinking due to the expansion of Catholic hospital networks.
These are states like Oregon, Washington, California, New York, and Connecticut, where abortion will remain legal despite the recent U.S. Supreme Court ruling overturning Roe v. Wade.
The concerns in these blue states relate to services such as contraception, sterilization and certain procedures for treating pregnancy-related emergencies. These services are widely available in secular hospitals but generally prohibited, along with abortion, in Catholic facilities under ethical and religious guidelines established by the United States Conference of Catholic Bishops.
Different perspectives on these services can clash when a Catholic hospital system seeks to acquire or merge with a nonsectarian hospital, as is currently the case in northeast Connecticut. State officials are weighing a bid by Catholic company Covenant Health to merge with Day Kimball Healthcare, a financially-struggling hospital and independent health-care system based in the town of Putnam.
“We need to make sure any new homeowner can provide a full range of care — including reproductive health care, family planning, gender-affirming care, and end-of-life care,” Connecticut’s attorney general said. , William Tong, a Democrat.
Lois Utley, an expert in tracking hospital mergers, said her organization, Community Catalyst, has identified more than 20 municipalities in blue or purple states where the only acute care hospitals are Catholic.
“We’re definitely going backwards in terms of overall reproductive health,” Utley said. “Catholic systems support many doctor’s offices, urgent care centers, outpatient centers, and patients seeking contraception will not be able to obtain it if their doctor is now part of that system.”
According to the Catholic Health Association, there are 654 Catholic hospitals in the United States, including 299 with obstetric services. The CHA says that more than one in seven hospitalized patients in the United States are cared for in a Catholic facility.
CHA President Sister Mary Haddad said Catholic hospitals provide a wide range of prenatal, obstetric and postnatal services while assisting about 500,000 births a year.
“This commitment is rooted in our respect for life, from conception to natural death,” Haddad said via email. “As a result, Catholic hospitals do not offer elective abortions.”
Protocols are different for serious emergencies when the mother “suffers from an urgent and life-threatening condition during pregnancy,” Haddad said. “Catholic Health clinicians provide all medically indicated treatments, even if they pose a threat to the unborn child.”
This approach is now reflected in several states that impose bans that only allow abortions to save a mother’s life. There are concerns that doctors governed by such prohibitions — whether by state law or Catholic directive — could endanger the health of a pregnant woman by refusing treatment while she is begins to show the adverse effects of a pregnancy-related problem.
In California, Democratic Sen. Scott Wiener is among those cautiously watching the proliferation of Catholic health care providers, who operate 52 hospitals in his state.
The hospitals provide “superb care to many people, including low-income communities,” Wiener said. But they “absolutely deny people access to reproductive health care as well as gender-affirming care (for transgender people).”
“It is the bishop, not professional standards, who dictate who can receive what health care,” Wiener said. “That’s scary.”
Charles Camosy, professor of medical humanities at Creighton University School of Medicine, says critics of the mergers fail to recognize a major benefit of expanding Catholic health care.
“These mergers are happening because Catholic institutions are ready to tackle the really tough places where others have failed to make money,” he said. “We should focus on what these institutions are doing in a positive way – stepping into the gap where hardly anyone else wants to go, especially in rural areas.”
This argument resonates in mostly rural northeast Connecticut, where Day Kimball serves an aging population of about 125,000.
Kyle Kramer, CEO of Day Kimball, said the 104-bed hospital had been looking for a financial partner for more than seven years and would soon face “very serious problems” if it had to go it alone.
Regarding the proposed merger, he said, “Change is always difficult.
However, he said Day Kimball providers would remain committed to comprehensive healthcare if the merger goes through, seeking to ensure patients are informed of all options regarding contraception, miscarriages and ectopic pregnancies. .
As for abortions, Kramer said Day Kimball never performed them for the sole purpose of terminating a pregnancy and that he would continue that policy if he partnered with Covenant.
Despite assurances, some residents fear the area’s only hospital will become Catholic property. Some opponents of the merger demonstrated outside the hospital last Monday.
“The public is being told that if you don’t take Covenant, you won’t get a hospital at all,” said Elizabeth Canning of Pomfret, Connecticut. “Which is, of course, scary. So people say, ‘Okay, well, we’ll take them. … It’s better than nothing.'”
“I received wonderful care here. That’s not my objection,” Canning continued. “I don’t want any religion involved in my health care.”
Sue Grant Nash, a retired social worker from Day Kimball Hospice in Putnam, described herself as religious but said she did not believe people’s values should be imposed on others.
“The very important articles of faith that Catholics may have, and which I fully respect, should not affect the quality of health care offered to the public,” she said.
There have been similar developments in other states.
—In Washington, Democratic state Senator Emily Randall plans to reintroduce a bill that would empower the attorney general to block hospital mergers and acquisitions if they jeopardize “the continued existence of accessible and affordable, including reproductive health care”. Governor Jay Inslee says he is in favor of such a measure.
The state has already passed a bill that prohibits religious hospitals in the state from restricting health care providers from providing medically necessary care to hasten miscarriages or terminate nonviable pregnancies, such as pregnancies ectopic. Under the new law, patients can sue a hospital if they are denied such care, and providers can also sue if they are disciplined for providing such care.
—In Oregon, the state has the new power to prohibit religious hospitals from acquiring or merging with another health care entity if it means access to abortion and other reproductive services would be reduced. A law that took effect March 1 requires state approval for mergers and acquisitions of significant health care entities.
Thirty percent of the state’s acute care beds are controlled by systems that restrict access to such services, according to Katie Shriver of the Service Employees International Union, who testified in support of the bill last year.
The law also allows the state to consider end-of-life options allowed by hospitals seeking to establish a footprint or expand in Oregon, which in 1994 became the first state to legalize medical assistance in die.
—In Newport Beach, Calif., Hoag Memorial Hospital Presbyterian spun off from a large Catholic health care system earlier this year. The split from Providence Health & Services, which runs 52 hospitals in seven states, came after a years-long legal battle.
In a 2020 lawsuit, Hoag said it was a “captive subsidiary” of Providence, which is headquartered more than 1,000 miles away in Washington state. Hoag was founded as a Presbyterian institution in 1952.
In 2013, Hoag joined St. Joseph Health, a chain of local Catholic hospitals, aspiring to expand access to health care in his area. In 2016, Providence Health absorbed St. Joseph with Hoag.
Hoag’s doctors questioned Providence’s decision to standardize treatment decisions at its hospitals and also balked at restrictions on reproductive care. In 2014, then-Attorney General Kamala Harris approved Health Systems affiliation on the condition that Hoag not be bound by Catholic health guidelines.
Hoag’s lawsuit said his “Presbyterian beliefs, values, and policies were compromised due to restrictions within the broader Catholic system.”
– In New York, two Democratic lawmakers this year proposed a bill that would have required the state’s health department to publish a list of health services not available at each general hospital so patients could be better informed .
Lawmakers said the failed legislation was needed to address ‘health care deserts’ where hospitals have closed or merged with religiously affiliated entities and reproductive care and other health services have been lost.
The New York Civil Liberties Union, which has raised concerns about Schenectady and Lockport hospitals’ affiliation with Catholic entities, said some New York patients had difficulty obtaining miscarriage services. and birth control pills from Catholic providers.
Crary reported from New York. Rachel La Corte, Associated Press reporter in Olympia, Washington; Andrew Selsky in Salem, Oregon; Adam Beam in Sacramento, Calif.; and Deepa Bharath in Los Angeles contributed.
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