3062.0 A blessed union? using certificate of need (CON) laws to protect reproductive care under catholic mergers

Session: Menstrual Health and Reproductive Rights

Program: APHA Committee on Womens Rights

Time: 10:30 - 11:30 AM

Presenter:

Aneri Suthar, MPH '23

Abstract

The growing trend of Catholic hospital mergers in America has restricted access to numerous health services deemed at odds with Ethical and Religious Doctrines (ERDs) that govern these hospitals. This exacerbates the public health problem of reduced availability of reproductive health services in the wake of the Dobbs decision, and creates a minefield for individuals—primarily women and trans people—seeking care in states in which services would otherwise be legal. Hospital mergers and acquisitions overall have been on the rise, purportedly to increase efficiency of operations, reduce overhead costs, and standardize quality of care due to economies of scale. However, evidence has shown hospital concentration to be linked to higher costs for patients, diminished quality of care, and workflow disruptions for staff.

Religious-based restrictions on care specific to Catholic hospitals supplement these issues, detrimentally affecting public health outcomes. Facilities within the Catholic health ministry, which today comprises over 600 hospitals and 1,600 long-term care and other health clinics, operate under 77 Ethical and Religious Directives, which are developed and approved by the United States Conference of Catholic Bishops (USCCB). In alignment with USCCB’s interpretation of Catholic doctrine, these Directives include bans on heterologous fertilization, homologous artificial fertilization, surrogate motherhood, direct sterilization, euthanasia or assisted suicide, contraceptive services and counseling, and abortion. Hospitals’ adherence to and interpretations of ERDs varies, with some complying with workarounds and other outright prohibiting services without exceptions.

This presentation has outlined the public health problem and legal landscape surrounding Catholic hospital mergers, identified relevant federal and state laws related to the problem, and devised a “toolbox” of possible strategies—focusing on Certificate of Need (CON) laws—and how to effectively implement them to address the problem and preserve reproductive care.