December 6, 2016; St. Louis Today

Over the last few years, NPQ has discussed concerns regarding women’s access to comprehensive health care in the growing number of Catholic hospitals throughout the country that have emerged due to mergers and alliances with for-profit hospitals. Now, advocates for women’s health must consider what it will mean that Anthony Tersigni, CEO of Ascension, the nation’s largest chain of Catholic hospitals, is scheduled to meet with the Trump transition team this week to weigh in on the Affordable Care Act (ACA).

Although a basic tenet of Catholic hospitals is to serve as many people as possible, there are clear rules regarding what services can and cannot be performed in relation to the unequivocal teachings of Catholicism. These are spelled out in a 12-page document of Ethical and Religious Directives for Catholic Health Care Services written by the United States Conference of Catholic Bishops. The requirement most commonly associated with the Directives is a ban on elective abortion, but the impositions on women’s health care does not end there. The Directives deny emergency contraception for rape victims, optional tubal ligation (getting “tubes tied” to prevent unwanted pregnancies), even contraception and fertility assistance.

Under the ACA, women’s health coverage has vastly improved. Not only are healthcare premiums equitable, but a number of services are covered under the Act with no patient copay required. These include access to necessary services that are not consistent with the Catholic Directives, such as contraceptives of all forms from hormonal birth control to tubal ligation.

Lois Uttley, director of MergerWatch, indicates that Catholic restrictions on the practice of health care are considered only after merger negotiations have completed, clearly placing business success ahead of patient care. Dr. Debra Stulberg, an associate professor at the University of Chicago, believes these mergers hinder the doctor-patient relationship: “They agree to do it in the interest of getting the sale through, without realizing that it will tie their doctors’ hands and limit the services their patients can get.” In fact, many doctors have implemented workarounds to ensure their patients get the care they need, mostly through referrals to outside providers.

The Catholic hospital mergers of late are analogous to what is currently happening with the ACA. While it appears that completely repealing the Act will be nearly impossible, gutting the ACA under the guise of cost savings will likely occur. As with the mergers, money will be considered before the impact on patient care is. And, with the leading Catholic hospital executive advising policy, Governor Mike Pence as the right hand man, and Representative Tom Price as the Secretary of Health and Human Services, this could very well mean that important aspects of women’s health care under the ACA will be on the chopping block.—Sheela Nimishakavi