Women’s Health Care at Risk

A wave of mergers between Roman Catholic and secular hospitals is threatening to deprive women in many areas of the country of ready access to important reproductive services. Catholic hospitals that merge or form partnerships with secular hospitals often try to impose religious restrictions against abortions, contraception and sterilization on the whole system.

This can put an unacceptable burden on women, especially low-income women and those who live in smaller communities where there are fewer health care options. State regulators should closely examine such mergers and use whatever powers they have to block those that diminish women’s access to medical care.

Gov. Steve Beshear of Kentucky, for example, recently turned down a bid by a Catholic health system to merge with a public hospital that is the chief provider of indigent care in Louisville. He cited concerns about loss of control of a public asset and restrictions on reproductive services.

The nation’s 600 Catholic hospitals are an important part of the health care system. They treat one-sixth of all hospital patients, and are sometimes the only hospital in a small community. They receive most of their operating income from public insurance programs like Medicare and Medicaid and from private insurers, not from the Catholic Church. They are free to deliver care in accord with their religious principles, but states and communities have an obligation to make sure that reproductive care remains available. This should be a central goal for government officials who have a role in approving such consolidations.

As Reed Abelson wrote in a recent report in The Times, these mergers are driven by shifts in health care economics. Some secular hospitals are struggling to survive and eager to be rescued by financially stronger institutions, which in many cases may be Catholic-affiliated. By one estimate, 20 mergers between Catholic and non-Catholic hospitals have been announced over the past three years and more can be expected.

The 2009 “Ethical and Religious Directives” issued by the United States Conference of Catholic Bishops warns that Catholic institutions should avoid entering into partnerships “that would involve them in cooperation with the wrongdoing of other providers.” Catholic hospitals have refused to terminate pregnancies, provide contraceptive services, offer a standard treatment for ectopic pregnancies, or allow sterilization after caesarean sections (women seeking tubal ligations are then forced to have a second operation elsewhere, exposing them to additional risks).

In one case, the sole hospital in a rural area in southeastern Arizona announced in 2010 that it would partner with an out-of-state Catholic health system, and would immediately adhere to Catholic directives that forbid certain reproductive health services. As a result, a woman whose doctors wanted to terminate a pregnancy to save her life had to be sent 80 miles away for treatment. A coalition of residents, physicians and activists campaigned against the merger and it was called off before it was finalized.

Over the past 15 years, MergerWatch, an advocacy group based in New York City, has helped block or reverse 37 mergers and reached compromises in 22 others that saved at least some reproductive services. As mergers become more common, state and local leaders would be wise to block proposals that restrict health services.