On Jan. 22, 1973, history was made for reproductive rights in the United States. The Supreme Court ruled that restricting abortions was unconstitutional, thus giving an individual the right to receive an abortion in any of the 50 states. But Roe v. Wade is a court decision, not a law, and only serves to protect reproductive rights from lawmakers, not companies nor individuals. In the 47 years since the ruling, countless individuals and religious groups have found other ways to limit access to abortion. We often hear about this happening in other states, but we could find ourselves in the same situation in Washington if Catholic Health Initiatives (CHI) Franciscan merges with Virginia Mason.
Virginia Mason is a Washington-based medical organization, providing clinical services in 250 different locations across the state, ranging from clinics to hospitals. Aside from offering access to abortions, Virginia Mason provides a variety of contraceptives, physician aid in dying, and gender confirmation surgeries.
CHI Franciscan is based out of Tacoma and is one of the largest health providers in Washington State. CHI Franciscan is also a part of CommonSpirit Health, one of the largest Catholic hospital systems in the entire nation. Both CHI Franciscan and CommonSpirit Health operate under the U.S. Conference of Catholic Bishops, thus Catholic health providers ban services such as terminating pregnancies or assistance in dying for the terminally ill.
On July 16, CHI Franciscan and Virginia Mason published a shared press release outlining the organizations’ potential to become a Joint Operating Company. Ketul J. Patel, CEO of CHI Franciscan, stated: “CHI Franciscan and Virginia Mason have partnered closely in recent years and through this collaboration, it has become clear there is much more we can do together.”
Mergers between local clinics and Catholic health care providers in the United States are not uncommon, as Catholic providers operate on a larger basis than smaller clinics, and merge with those clinics to provide better financial support for patients and communities. This issue is also not new to the state, as when Seattle’s Swedish medical center merged with Catholic nonprofit Providence Health & Services, all services related to providing abortions were terminated. As the COVID-19 pandemic has posed new economic challenges for smaller and locally based clinics, Catholic health care mergers could continue to become more common.
If Virginia Mason and CHI Franciscan do integrate into a joint health services system, Virginia Mason would have to comply with CHI Franciscan’s health requirements. The potential effects this merger could have for many Washingtonians have prompted a response from multiple health care and civil rights organizations such as the ACLU of Washington, Northwest Abortion Access Fund, Coalition for inclusive Health Care, and many more. On Tuesday, July 21, the organizations released a joint statement on the effects of the merger for healthcare access, affirming, “Virginia Mason’s plan jeopardizes access to reproductive and end of life care, subordinating patients’ health care needs to religious doctrine.”
Catholic providers often do not clearly state what services are prohibited under their policies, which is why it would be harder for a state legislative initiative to block a merger that can impact patients in Washington. Without the necessary legal protections, it becomes easier for providers like CHI Franciscan to prohibit certain procedures that individuals should have access to, without facing scrutiny under constitutional law. Washington State is often viewed as being vocally pro-choice, but that is not enough to prevent faith-based companies like CHI Health from finding ways to limit certain health freedoms. Representative Eileen Cody, the Chair of the House health committee, stated: “The people of Washington have voted many times for access to abortions and Death with Dignity, and it’s really frustrating that hospitals won’t be delivering those services.”
Without hospital or clinical resources for abortions or contraceptives, Planned Parenthood chapters would be the primary resource in the state to provide such services. Planned Parenthood helped set up a clinic near the Swedish Medical Center to provide services that Swedish could no longer support under its association with Providence Health Services, however, it is unclear if a similar resource would be possible if Virginia Mason eventually joins CHI Franciscan.
If the merger is successful, the integrated health system will be finalized at the end of this year. Until then, it remains to be seen whether advocacy organizations are triumphant in their efforts to prohibit the merger, and exactly where reproductive freedoms lie in Washington State.