Tag: Birth

Birth control access can be limited in places with Catholic health systems : Shots

Dania
Birth control access can be limited in places with Catholic health systems : Shots

Catholic health care systems can limit access to birth control.

Rich Pedroncelli/AP


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Rich Pedroncelli/AP

Catholic health care systems can limit access to birth control.

Rich Pedroncelli/AP

Last week, students returning to campus at Oberlin College in Ohio got a shock: A local news outlet reported that the campus’ student health services would severely limit who could get contraception prescriptions. They would only be given to treat health problems — not for the purpose of preventing pregnancy — and emergency contraception would only be available to victims of sexual assault.

It turned out the college had outsourced its student health services to a Catholic health agency – and like other Catholic health institutions, it follows religious directives that prohibit contraception to prevent pregnancy. They also prohibit gender-affirming care.

“I would characterize the student’s reaction as outrage,” says Remsen Welsh, a fourth-year Oberlin student and co-director of the student-run Sexual Information Center on campus. “A lot of people in my circles were sending [the news story] around like, what is happening?”

Although the college quickly came up with a new plan to offer reproductive health services to students on campus, the incident at Oberlin shows the wide reach of Catholic health care in the U.S., and how the rules these institutions follow can limit access to contraception.

Now that many states – including Ohio – have adopted restrictions or outright bans on abortion, that’s also raised the stakes for contraception access.

Religious restrictions affect many health care settings

Issued by the U.S. Council of Catholic Bishops, the Ethical and Religious Directives that guide Catholic health care systems “prohibit a broad swath of reproductive care,” including birth control pills, IUDs, tubal ligation and vasectomies, says Dr. Debra Stulberg, a professor of family medicine at the University of Chicago who has researched how these directives play out in health care.

Catholic hospitals have long been a mainstay of health care in America. And these days, the directives apply to a wide range of settings where people seek reproductive health care – including urgent care centers, doctors’ offices and outpatient surgery centers that have been bought by or merged with Catholic health systems.

They can also apply when Catholic health agencies are hired to manage health care services for other institutions, which is what happened at Oberlin.

Four of the 10 largest health care systems in the country are Catholic, according to a 2020 report. In some counties, they dominate the market. In 52 communities, the report found, a Catholic hospital is the only one around within a 45-minute drive.

“After all this consolidation, this is where it shakes out, where we’ve got about 40% of reproductive age women living in areas with high or dominant Catholic hospital market share,” says Marian Jarlenski, a health policy researcher at the University of Pittsburgh, who examined the data in 2020.

‘Not transparent at all’

Patients often aren’t aware that these restrictions might affect the care they get, says Lois Uttley,

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How Billing Turns a Routine Birth Into a High-Cost Emergency

Dania
How Billing Turns a Routine Birth Into a High-Cost Emergency

Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son.

Wells Salerno went into labor on the eve of her due date, in the early weeks of coronavirus lockdowns in April 2020. She and her husband, Jon Salerno, were instructed to go through the emergency room doors at Poudre Valley Hospital in Fort Collins, Colorado, because it was the only entrance open.

Despite the weird covid vibe — the emptiness, the quiet — everything went smoothly. Wells Salerno felt well enough to decline the help of a nurse offering to wheel her to the labor and delivery department. She even took a selfie, smiling, as she entered the delivery room.

“I was just thrilled that he was here and it was on his due date, so we didn’t have to have an induction,” she said. “I was doing great.”

Gus was born a healthy 10 pounds after about nine hours of labor, and the family went home the next morning.

Wells Salerno expected the bill for Gus’ birth to be heftier than that for her first child, Hank, which had cost the family a mere $30. She was a postdoctoral fellow in California with top-notch insurance when Hank was born, about four years earlier. They were braced to pay more for Gus, but how much more?

Then the bill came.

The Patient: Caitlin Wells Salerno, a conservation biologist at Colorado State University and a principal investigator at Rocky Mountain Biological Laboratory. She is insured by Anthem Blue Cross Blue Shield through her job.

When Wells Salerno went into labor in April 2020, she and husband Jon were told to go through a Fort Collins, Colorado, hospital’s emergency room doors because it was the only entrance open. Their medical bill later included a $2,755 charge for Level 5 emergency services.(Rae Ellen Bichell / KHN)

Medical Service: A routine vaginal delivery of a full-term infant.

Total Bill: $16,221.26. The Anthem BCBS negotiated rate was $14,550. Insurance paid $10,940.91 and the family paid the remaining $3,609.09 to the hospital.

Service Provider: Poudre Valley Hospital in Fort Collins, Colorado, operated by UCHealth, a nonprofit health system.

What Gives: In a system that has evolved to bill for anything and everything, a quick exam to evaluate labor in a small triage room can generate substantial charges.

The total bill was huge, but what really made Wells Salerno’s eyes pop was a line for the highest level of emergency services. It didn’t make any sense. Was it for checking in at the ER desk, as she’d been instructed to? She recalls going through security there on her way to labor and delivery, yet there was a $2,755 charge for “Level 5” emergency department services — as if she had received care there like a patient with a

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