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Merger Could Make Catholic Health Giant ‘Too Big to Fail,’ Threatening Reproductive Health (Updated)

Amy Littlefield

“These systems will have even greater financial and political clout and it will become more and more difficult for people to suggest that denying women reproductive health care is not appropriate."

UPDATE, March 28, 6:00 p.m.: The Wall Street Journal reported Wednesday that Ascension and Providence St. Joseph Health had halted merger talks, due in part to the changing health-care landscape; people familiar with the discussions told the Journal that the talks would be unlikely to resume soon.

Two Catholic hospital giants are considering merging to create the largest hospital operator in the United States, granting unrivaled power to a system that would restrict access to reproductive health care.

The Wall Street Journal reported Sunday that the merger of Ascension and Providence St. Joseph Health would create “an entity of unprecedented reach, with 191 hospitals in 27 states and annual revenue of $44.8 billion.”

The article omits any mention of the threat to reproductive health care posed by the merger. But reproductive health advocates expressed grave concerns about the consolidation of power by an entity that restricts access to such care on religious grounds.

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“These systems will have even greater financial and political clout and it will become more and more difficult for people to suggest that denying women reproductive health care is not appropriate,” Lois Uttley, director of MergerWatch, told Rewire.

Catholic hospitals, which account for one in six acute-care beds nationwide, follow directives from the U.S. Conference of Catholic Bishops, which restrict access to gender-affirming care, contraception, sterilization, abortion care, and end-of-life options. As these health systems expand their clout, the Trump administration and the U.S. Supreme Court have moved to give them broad new leeway to restrict reproductive health access for patients and workers.

Catholic health systems have been at the forefront of a trend toward consolidation in the wider health-care industry. Last week, Dignity Health and Catholic Health Initiatives announced they had signed a definitive agreement to “create a new, nonprofit Catholic health system.”

“If you think back to the financial crisis, one of the problems was banks that were too big to fail, and now I fear we are heading towards hospital systems that are too big to fail,” Uttley told Rewire. “Everyone will be concerned with trying to make sure they survive. … Politicians I think will be loath to take steps that in any way unsettle these large systems.”

Ascension is the largest nonprofit health operator in the United States, and the largest Catholic health system in the world. A Rewire investigation in September revealed how a doctor at an Ascension hospital in Milwaukee was forced to watch her patient sicken gravely during a miscarriage because of the hospital’s adherence to the Catholic directives. Last year, the American Civil Liberties Union filed a complaint against Ascension for denying a woman with a brain tumor a tubal ligation during her cesarean section, even though her tumor made pregnancy potentially life threatening.

The degree to which hospitals follow the directives can vary widely, even within the same health system. Providence and Ascension did not respond to questions from Rewire about how the proposed merger would affect access to reproductive health care.

Tell us your story. Have religious restrictions affected your ability to access health care? Email [email protected]

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