Washington State Bill Seeks To Regulate Hospital Mergers, Care Access

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Dive Brief:

• The Washington state Senate passed a bill last week that would allow the attorney general to reject hospital mergers perceived to limit care access, including reproductive, gender-affirming, emergency and end-of-life care.
• Under the act, the attorney general would determine through a “public process” whether proposed mergers would detrimentally affect accessible and affordable care for at least 10 years following a deal. The AG would be able to conditionally approve or reject transactions.
• If passed by the state House, the law may reduce tie-ups between secular and religious hospitals, which operated 45% of Washington beds as of 2021, according to a report from the Seattle Times. Nationwide, many religiously affiliated hospitals operate under ethical and religious directives and do not offer abortion or sterilization services.

Dive Insight:

The “Keep Our Care Act” ​​passed the Washington Senate in a 28-21 vote on Thursday. In a statement, the bill’s sponsor, Sen. Emily Randall, (D-Bremerton), said the policy was about ensuring Washingtonians had meaningful access to their legally enshrined reproductive rights.

“A right without access is not a right,” she said.

Only Oregon has a similar law on the books. The state gave officials the ability to deny healthcare deals that restricted essential care access beginning in 2022. 

In Washington, a series of secular and religious hospital mergers preceded the bill’s passage.

Washington-based CHI Franciscan and Virginia Mason Health System merged in 2021 to become Virginia Mason Franciscan Health. Virginia Mason’s parent company, CommonSpirit Health, is both one of the nation’s largest nonprofit health systems and the nation’s largest Catholic healthcare chain.

The American Civil Liberties Union opposed the deal in comments to regional outlet MyNorthwest, because the Catholic medical network would not provide abortion services or gender-affirming care.

In 2022, Swedish Health Services and the Catholic health system Providence united to become Providence Swedish.

During a Jan. 24 Senate session, proponents of the bill testified that it would create oversight and accountability into the merger process, and allow the AG to thoroughly evaluate conflicts of interest. Supporters include spokespeople from Pro-Choice Washington, the Economic Opportunity Institute and racial and economic nonprofit lobbying group WashingtonCAN! 

However, the bill did not pass without critique. Spokespeople from the Washington State Hospital Association and Washington State Medical Association testified against the bill. Critics took issue with the amount of power handed to the AG to review deals and worried about the options available for financially strapped hospitals to pursue mergers that met lawmakers’ specifications.

“This bill is a blunt instrument that will stifle the ability of vulnerable hospitals and providers to find partners and keep providing care critical to their communities,” one bill opponent said during a Jan. 26 Senate session.

The policy has advanced to the State House.