[Nearly two in five women of reproductive age may face restricted
access to...abortion, contraception and sterilization, because
they...live in a county where Catholic hospitals make up a high share
of the market...] [[link removed]]

NEARLY 2 IN 5 WOMEN OF REPRODUCTIVE AGE MAY BE STUCK WITH CATHOLIC
HEALTH CARE  
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Amy Littlefield
February 15, 2020
Truthout
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_ Nearly two in five women of reproductive age may face restricted
access to...abortion, contraception and sterilization, because
they...live in a county where Catholic hospitals make up a high share
of the market... _

Many patients have no choice but to visit Catholic hospitals., Blue
Planet Studio via Getty Images

 

Nearly two in five women of reproductive age may face restricted
access to services like abortion, contraception and sterilization,
because they happen to live in a county where Catholic hospitals make
up a high share of the market, according to a sweeping new report
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in _JAMA Network Open_.

In the first-ever study of its kind, researchers analyzed patient
discharge data in almost every U.S. county to determine the market
share of Catholic hospitals. They discovered that in 35 percent of
U.S. counties, Catholic hospitals have a high or dominant market
share, meaning they make up more than 20 percent of patient
discharges. Combined, these counties serve an estimated 39 percent of
U.S. women of reproductive age.

The findings have important implications for access to reproductive
health care in these communities. Patients in Catholic hospitals have
had their care dangerously delayed while suffering miscarriages
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been pressured
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into burying their miscarried fetuses and had their gender-affirming
surgeries canceled
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on religious grounds. But many patients have no choice but to go to
one of these hospitals, the study shows. In 101 counties, Catholic
hospitals had a market share of more than 70 percent. In seven U.S.
counties, that share was more than 90 percent, data provided by the
researchers to _Truthout _showed.

“If you thought about a particular type of phone having 80 percent
of the market, that would be shocking to people, right?” said Marian
Jarlenski, an author of the report and assistant professor at
University of Pittsburgh Graduate School of Public Health. “We
thought it was interesting and significant just how many counties fell
into that range of more than 20 percent of the market, of all the
hospital discharges, being attributable to Catholic hospitals,”
Jarlenski added.

While legal restrictions on reproductive health care have proliferated
in Republican-led states in the South, the study underscores how
Catholic hospitals tend to dominate areas of the country that are seen
as more progressive on reproductive health access, including the
Pacific Northwest.

“The Upper Midwest, the Pacific Northwest and to a lesser extent,
the Eastern megalopolis from New York to Boston, are some of the areas
with more restricted access,” said Coleman Drake, another study
author who is also an assistant professor at University of Pittsburgh
Graduate School of Public Health. “It’s interesting to see this
variation occurring in places that one normally doesn’t associate
with restricted access.”

Whether a patient is forced to seek care in a Catholic hospital
depends not only on where they live, but on their insurance network. A
study last year in _Contraception _found that in the Chicago area,
Medicaid-managed care plans were disproportionately funneling women of
color into Catholic facilities
[[link removed]].

Patients in Catholic hospitals have had their care dangerously delayed
while suffering miscarriages, been pressured into burying their
miscarried fetuses and had their gender-affirming surgeries canceled
on religious grounds.

While the most recent study did not look at Medicaid plans, the
researchers did look at plans sold in Obamacare marketplaces.
Nationwide, the median marketplace plans in most counties had a lower
share of Catholic hospitals than the counties overall. But in 440
counties, patients can inadvertently select a health insurance network
that has a Catholic hospital market share of more than 80 percent.
That is particularly concerning because of how hard it is to determine
ahead of time whether a plan is dominated by Catholic options.

There are no regulations requiring marketplace health insurance plans
to disclose how facilities in their networks restrict reproductive
health care. Less than a third
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of Catholic hospital websites nationwide mention how the facility’s
religious affiliation impacts care, and more than a third
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of women who rely on Catholic hospitals for care don’t realize the
facility is Catholic, prior research has found.

“I worry about the ability of people to make informed choices
here,” Drake told _Truthout._

Finally, the researchers examined the demographics of residents in
counties where Catholic hospitals are dominant. They found that
overall, populations in counties with high or dominant Catholic
hospital market shares were more likely to be white, Latino, more
educated, and have higher annual median incomes than their
counterparts in other counties. They were also slightly more likely to
be Catholic. But the differences were small.

A prior study
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by researchers at Columbia Law School’s Law, Rights, and Religion
Project found that women of color were more likely to give birth in
Catholic hospitals. That suggests that Black women may be directed to
Catholic hospitals based on factors other than where they live.

“If we see that Black women are more likely to deliver in Catholic
facilities, it would suggest that their health plans or their
obstetric providers are directing them to Catholic institutions,”
Jarlenski said.

The researchers said they hoped their study would draw attention to a
reproductive health care access issue that has received relatively
little scrutiny compared to legal restrictions on abortion.

“The main thing we’re trying to do here is just shed light on this
issue and provide some more transparency,” Jarlenski said. “I hope
to provide health care systems and policymakers the impetus to think
about aligning the services with the needs of the patient.”

Amy Littlefield is a freelance investigative reporter focused on the
intersection of religion and health care.

Copyright, Truthout [[link removed]]. Reprinted with
permission. May not be reprinted without permission.

Truthout publishes a variety of hard-hitting news stories and critical
analysis pieces every day. To keep up-to-date, sign up for our
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