Expansion of Catholic Hospital Chains Limits Availability of Abortion and Other Reproductive Services in Illinois
Despite a new law enshrining reproductive health care as a “basic right” in Illinois, trends in the hospital industry are limiting the availability of contraception, sterilization, and abortion.
The JB Pritzker government signed the Reproductive Health Act last month, removing virtually all state restrictions on these procedures. At the same time, consolidation brings more Illinois hospitals under the control of expanding Catholic organizations that do not provide the full range of reproductive care.
As hospitals come under pressure to gain market share, control health care costs and increase profitability, many financially strong Catholic chains have grown – acquiring denominational and secular facilities along the way. Catholic hospitals follow a set of rules that prohibit or severely restrict contraception, fertility treatments, sterilization procedures, and abortions.
As they place these restrictions on acquired hospitals, some women have to travel further afield to find facilities that provide such services. This is especially true for women covered by most Medicaid managed care insurance plans in Cook County, which rely heavily on Catholic hospitals.
“The (Reproductive Health Act) is important, but if we don’t have health care providers willing and able to provide the services, then it is not meeting the needs of patients,” says Dr. Debra Stulberg, Associate Professor of Family Medicine at the University of Chicago.
Data from the Illinois Health & Hospital Association shows that the number of Catholic hospitals in Illinois has increased 7% over the past five years, while non-Catholic hospitals have declined 1%. Forty-seven of the state’s 210 hospitals belong to Catholic systems, up from 44 of 209 in 2014.
These facilities operate under the Ethical and Religious Guidelines for Catholic Health Services, or ERDs, developed by the United States Conference of Catholic Bishops. MacNeal Hospital in Berwyn adopted the rules last year when Loyola Medicine, owned by Trinity Health, bought it from Tenet Healthcare. In northern Illinois, the Greenville Regional Hospital followed suit when it joined the Hospital Sisters health system in 2016 and changed its name to Holy Family Hospital.
Insurance plans that contract with a large number of Catholic hospitals can leave women without practical options for reproductive services.
Darolyn Lee’s Medicaid managed care plan (the now defunct Family Health Network) referred her to Mercy Hospital & Medical Center in 2017 when she called to replace her nearly expired contraceptive implant. In a complaint to the Illinois Department of Human Rights accusing Mercy of discrimination, Lee alleges that a primary care physician she saw in Mercy said that “all women should be forced to have children ”before referring her to a gynecologist at the Near Catholic Hospital on the south side.
Lee, 38, who lives on the Hyde Park and Kenwood border, returned to Mercy for the appointment a few weeks later but the gynecologist refused to replace her implant, according to the complaint. She says neither the health plan nor the doctors made it clear that Catholic hospitals do not prescribe contraception in an attempt to prevent pregnancy.
“Healthcare professionals are supposed to be neutral,” says Lee, who ultimately had the implant replaced at Planned parenthood.
Loyola spokeswoman Chris Vicik, who also represents Trinity-owned Mercy, declined to comment on Lee’s account due to privacy laws. In Mercy’s response to Lee’s complaint, the hospital denied that it discriminated against her. Department of Human Rights investigators dismissed the complaint, but Lee has until September to appeal.
Stulberg’s latest research reveals that Cook County women who are enrolled in the state’s Medicaid managed care program do not have consistent access to family planning services. Some 38% of Cook County hospitals with labor and delivery services are Catholic, according to the report. Meanwhile, Catholic hospitals made up more than 38% of network hospitals for five of the seven Medicaid managed care plans available in 2018, limiting patients’ options for family planning services, Stulberg says.
Women of color in the county have even fewer options: 85% of black and Hispanic women were enrolled in one of five plans with a strongly Catholic network, compared to 75% of white women, according to the study. Meridian Health Plan and NextLevel Health had the lowest percentages of Catholic hospitals in the network, at 37% and 36%, respectively.
If a Medicaid managed care plan does not have networked providers that offer family planning services, the plan must pay for patients to receive that care outside the network, the health department spokesperson said. of Illinois Family Services John Hoffman in an email.
Obstetrician and gynecologist Dr Jamil Abdur-Rahman, who works at Vista Health System in Gurnee, left his practice at the Ottawa Regional Hospital shortly after it was acquired by Catholic OSF HealthCare in 2012. Abdur-Rahman says that he and several other doctors feared their hands would be tied in cases where women were at risk of infection or death if they could not have an abortion.
“You sign a contract at the hospital saying that you are going to follow the DRE … but you also have a responsibility in medicine,” says Abdur-Rahman. “And you have a forensic responsibility to the patient to do what is medically appropriate… We thought we could easily find ourselves caught between a rock and a hard place.