space traveling warriors tier list : Oregon’s hospital merger law could further protect access to abortion in the state

When it comes to the national fight for access to abortion unleashed by the US Supreme Court, Oregon has a powerful tool not found anywhere else.

from Oregon toughest law in the country regulating the healthcare mergers that were in force this year gives state authorities the authority to deny significant healthcare industry consolidations that would result in higher prices, less competition, or restricted access.

Significantly, this power is aimed at, among other things, protecting access to abortion and other reproductive health services, such as restricting the expansion of religious providers. And now, in the wake of the Supreme Court’s decision overturning Roe v. Wade, Washington state lawmakers are renewing their efforts to follow Oregon’s lead and pass a similar law. Washington state senator Manka Dhingra recently said Axios there is “definitely a way forward” to do so.

In Oregon, Representative Andrea Salinas, D-Lake Oswego, who last year sponsored merger law, House Bill 2362told The Lund Report that Oregon law is even more important now that the Supreme Court’s decision has spawned a state-by-state struggle over abortion rights and access.

“I would say it’s an important tool,” she said.

Similar to some other states, Oregon also has the Reproductive Health Equity Act of 2017. It protects the right to abortion and seeks to ensure that abortion, family planning, and postpartum care are available to all Oregonians.

But, Salinas said, just because something is a right doesn’t mean providers must provide it. That’s what Oregon’s merger law tried to address.

It requires the state to consider whether services would be reduced when deciding whether or not to approve a merger, acquisition or consolidation among healthcare providers, Salinas explained.

Ambulances stack outside the emergency department, awaiting admission of patients at Salem Health in Salem, Oregon, January 27, 2022.

Kristyna Wentz-Graff / OPB

In Washington, Governor Jay Inslee made a similar remark to Axios. “It doesn’t do much good if you have legal protection — if you’re safe from the GOP and the Supreme Court — but there’s no one to provide the service,” he said.

An Do, executive director of Planned Parenthood Advocates of Oregon, told The Lund Report in an email that the law has gained importance. “In the wake of this Supreme Court ruling, with millions of people now being forced to travel hundreds, if not thousands of miles to access abortion, preventing the loss of essential health services during a merger is more critical than ever before.”

Likewise, Felisa Hagins, policy director for SEIU Local 49, told The Lund Report in an email that “The review of essential services will be critical to protecting the rights of Oregon residents and we are proud to be a part of this legislation aimed at for the future”.

Catholic healthcare in focus

The debate over the merger bill in the Oregon Legislature made reference to complex arguments about market power, the effects of cost mergersand if the new law impaired collaboration or threaten the survival of rural hospitals.

However, it was no secret that the bill was intended, in part, to combat the steady expansion of Catholic health care systems, which do not provide abortions or referrals to abortion providers. Advocates of reproductive health and gender-affirming services have long viewed these health systems as a major threat.

The Service Employees International Union, which supported the account, cited a finding from a Health Affairs article. As of 2018, Providence Health & Services – Oregon’s largest Catholic system – employed “the largest share of physicians in Portland (28.7%) and nearly tripled its market share in (one) two-year period.”

A report released by the Community Catalyst group in 2020 found that 30% of acute care hospital beds in Oregon were in Catholic facilities.

In contrast, a study years ago indicated that only 14% of Oregonians identify as catholic.

Under Oregon’s merger law, before Providence can acquire additional major providers, the state must review whether the transaction would reduce access to healthcare. This includes abortion and gender-affirming services.

Providence, which has aggressively opposed the project, has denied some of the criticism leveled at its services, but admitted that “some services are not provided in accordance with the Ethical and Religious Guidelines for Catholic Health Services.”

In addition to Planned Parenthood, NARAL Pro-Choice Oregon and Compassion and Choices Action Network supported the project, as did Basic Rights Oregon and others.

At the time, sources said that within the Democratic caucus, discussion of the bill often boiled down to a simple argument that support equated to a pro-choice vote.

“Yes, absolutely,” Salinas said of the internal debate. But she said support for the project was about much more than abortion.

“Not only do we not have enough access to abortion care, but only basic reproductive health care, preventive care service in Oregon,” she said.

Salinas said he heard from fellow lawmakers that some Oregonians had to drive two hours to get their annual Pap smear for cervical cancer.

“That seems too extreme to make your annual visit,” she said.

this story was produced by The Lund Report, an independent, non-profit news site covering Oregon-focused health care. You can contact Nick Budnick at nick@thelundreport.org or on Twitter at @NickBudnick.

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