Washington, D.C. — By 2020, at least 1 in 6 U.S. hospital beds were located in Catholic hospitals. While consolidation has been increasing in American health care, Catholic health care providers are uniquely constrained by religious directives that restrict contraception access, abortion, gender-affirming care, fertility treatments, and other forms of lifesaving reproductive health care.
As the market share of Catholic hospital networks continues to grow, patients are left with fewer choices, charged higher prices, and forced to face greater challenges in accessing high-quality reproductive care. A new report from the Center for American Progress discusses this aspect of health care consolidation and recommends policies to slow consolidation, increase transparency, and protect patients’ access to care.
Key findings include:
- From 2001 to 2020, Catholic provider growth rate was 28.5 percent, while the number of non-Catholic hospitals declined by nearly 14 percent over the same period. By 2020, four of the 10 largest U.S. hospital systems were Catholic.
- A 2024 study found that of the 132 U.S. counties in which all available hospitals were faith-based institutions, 118 (or 89 percent) were Catholic.
- A survey from 2008–2009 found that more than half of all OB-GYNs practicing in U.S. Catholic hospitals report experiencing conflict with their institution over religiously based policies.
- In Alaska, Iowa, Washington, Wisconsin, and South Dakota, more than 40 percent of acute care beds are located in hospitals operating under Catholic health restrictions.
- To better preserve access to care, the Federal Trade Commission should modify or block hospital mergers that reduce competition, including those that eliminate key service lines such as reproductive care.
- State policymakers should provide attorneys general additional resources to evaluate hospital mergers for effects on access to reproductive health. States can also pass legislation to require hospitals to publicly disclose service limitations
“The antitrust laws very clearly prohibit conduct that substantially lessens competition in any line of commerce,” said Barak Richman, Alexander Hamilton professor of business law at George Washington University and co-author of the report. “We are identifying a particular—and particularly important—line of commerce that antitrust enforcement has previously overlooked, and we are confident that more enforcement means more competition, more consumer choice, and more health care access.”
“As Catholic health systems continue to acquire other hospitals, it’s crucial that patients retain meaningful access to sexual and reproductive health care,” said Kierra Jones, senior policy analyst for Health Policy at CAP and co-author of the report. “Enforcing antitrust laws, promoting transparency, and empowering state policymakers and communities to challenge harmful mergers can help ensure that this care remains accessible to every American, regardless of where they live.”
Read the report: “Growing Market Power Among Catholic Hospitals Restrains Access to Reproductive Health Care” by Bailey Sanders, Barak Richman, Kierra Jones, Andrea Ducas, and Samuel Doernberg
For more information or to speak with an expert, contact Mishka Espey at [email protected].