HB 1218 requires health care facilities to say what procedures they won't offer for non-medical reasons

A proposed bill in Colorado would require all hospitals to tell the public up front what procedures they won’t perform for non-medical reasons.

The biggest effect of that bill? It would require Catholic hospitals in the state to be honest about the limitations of their offerings.

Here’s why this matters in practice.
How Catholic hospitals harm patients

Suppose you’re giving birth and having a C-section. You might decide that you’re also done having kids and you’d like to have your tubes tied so there are no unplanned pregnancies in your future.

The doctor is already performing surgery, so performing a tubal ligation actually lets you kill two birds with one stone. It’s a safe procedure. Medical professionals even say that if you want to get your tubes tied, doing it during a C-section is a good idea because it doesn’t require an additional surgery. Nearly 30% of married adult women in the U.S. have had the procedure done. Not a big deal!

But what if you’re at a Catholic hospital?

Doctors there will perform a C-section, no problem, but they will not perform a tubal ligation. Why not? Because their directives don’t come from medical professionals, but rather the United States Conference of Catholic Bishops. And since anything involving contraception is forbidden in the faith, even a normal procedure like tubal ligation isn’t permitted. This rule applies even if future pregnancies would put the woman’s life in danger.

By and large, and with very few exceptions, the USCCB does not allow Catholic hospitals to perform any procedures that violate Catholic doctrine. Hospitals that violate those rules risk getting shut down. Even if the doctors and nurses who work there know that a procedure is necessary for the health of the patient, their expertise takes a backseat to the whims of religious leaders.

A lot of people know that Catholic hospitals won’t perform abortions, but fewer know how radical that policy is. Even if you set aside elective abortions, patients who have ectopic pregnancies (and whose lives are at risk) would be in danger if they went to a Catholic institution.

A normal hospital could give that patient a drug to induce an abortion... or just remove that fertilized egg through surgery. Not Catholic hospitals, though. They might make doctors remove a woman's entire fallopian tube to prevent something fatal, reducing her ability to get pregnant in the future, even though it's medically unnecessary, because that's what their faith tells them to do.

What if a woman has a miscarriage? That's already emotionally draining, but Catholic hospitals make things worse. Normal hospitals might induce an abortion to make sure the embryonic tissue is removed from a woman's body to prevent infection. Not Catholic hospitals. They require doctors to wait until a woman is infected before providing treatment.

What about contraception? Catholic hospitals won’t dispense it. If a victim of sexual assault needs birth control immediately, and a Catholic hospital happens to be the one nearby, it may not help her. If there's any chance the victim is already pregnant when the hospital sees her, that help is even less likely.

Catholic hospitals also won't perform vasectomies on men because those would interfere with natural pregnancies in the future.

Nor will they help women who want to get pregnant by using a sperm donor.

They also won’t help couples use a surrogate mother to give birth to their biological child because that would also be seen as "gravely immoral."

Catholic hospitals are equally awful at the other end of life. What if you're an elderly person who is dying of a terminal disease, constantly in pain, and eager to end life on your own terms, peacefully, while you are able to make those kinds of decisions?

That ability to end your life, known as euthanasia or death with dignity, is legal in Colorado, but if you're in a Catholic hospital, too bad. You will just have to suffer. They will not assist you in those cases.

Catholic hospitals will also not help you if you're a transgender person who wants (or needs) hormone treatment, or a hysterectomy, or a mastectomy.

In short, Catholic hospitals have an obligation to the Catholic Church, not their patients. The people they hurt the most tend to be low-income people, women, and LGBTQ individuals. Even if they have insurance, it's possible their policies require them to go to a Catholic hospital, where their options are severely limited.

If we were just talking about a handful of hospitals, that would be one thing. But Catholic hospitals are taking over the country. According to the health advocacy group Community Catalyst, as of 2020, the 10 largest Catholic health care systems now "own or control 394 short-term acute care hospitals." They also own or control 864 urgent care centers, 385 ambulatory surgery centers, 274 physician groups, and more than 1,100 hospitals overall. Four of the 10 largest health care systems in the country are affiliated with the Catholic Church.

More than 30% of births in the U.S. now happen in a Catholic hospital.
How Catholic hospitals hide their policies

Here's what's really sneaky about this. Much like evangelical Christian bakers who don't advertise their bigotry with a sign on the door saying who they will or won't bake a cake for, Catholic hospitals don't always advertise the services they won't perform—or the fact that they’re Catholic.

Sometimes, these hospitals are named St. Something or Mercy Hospital and there's a cross in the logo and it's easy to figure out the connection. But often, their names are ambiguous on purpose. Like Dignity Health. You wouldn't necessarily know that's a religiously affiliated hospital.

In fact, in 2018, the New York Times looked at the websites of 652 Catholic hospitals (gift article) and found that two-thirds of them didn't even make it clear they were Catholic. You needed at least three clicks from the home page to confirm that. Only 3% of those hospitals listed what procedures they do not perform.

What that means is that patients may not know which hospitals are Catholic, and most of them won’t have any idea what procedures are banned until it's way too late.
How Colorado is trying to fix this problem

That’s what the people behind House Bill 1218 in Colorado are hoping to fix. Called the “Patients’ Right to Know Act” and sponsored by State Reps. Kyle Brown and Brianna Titone (a non-theistic legislator) and State Sen. Sonya Jaquez Lewis, the bill would require all hospitals and community clinics to post on their websites a detailed list of what procedures “are not generally available… or that are subject to significant restriction” for non-medical reasons.

That would allow patients to know beforehand what the hospitals offer. Doctors would be encouraged to share that information with patients.

The bill would also task the state’s Department of Public Health & Environment with creating a form for health care facilities to fill out documenting which services, for non-medical reasons, “are not generally available… or that are subject to significant restriction.” The department would then publish those forms on their website, update the information every two years, and investigate any complaints regarding non-compliance.

Basically, the bill forces hospitals to be honest and transparent, giving patients more complete information if they’re in the position of making a choice about where to get treatment.

Many Catholic hospitals, as we’ve seen, can’t be trusted to do that on their own.

Yesterday, in a phone call with me, Rep. Brown said he was compelled to sponsor this bill because he believes every Coloradan deserves access to comprehensive health care. “Part of that is understanding which providers can provide care when they need it,” he added.

Noting that it may not be easy for patients to change facilities, and citing anecdotes from constituents who have found a lack of clarity at local hospitals, he said, “You shouldn’t have to wait till you’re in the hospital to find out certain kinds of health care are not available.”

American Atheists has been pushing this kind of legislation for years now. In 2015, they even offered model legislation to any lawmakers willing to take up the cause. One staffer at the time defended the move by saying, “Patients must be able to make fully informed decisions about their health care… This legislation would help patients get the information they need to navigate the increasingly complicated—and increasingly religious—health care marketplace.”

It’s finally happening.

In fact, when the bill was in front of the House Health & Insurance committee on Friday, American Atheists’ Vice President for Legal and Policy Alison Gill spoke at the hearing (at the 1:48:45 mark). In addition to pointing out how this bill gave patients informed consent, Gill noted that, in the wake of the Dobbs decision, more patients were seeking abortion care and needed to know where they could receive it.

The bill made it out of committee on an 8-2 vote. It now heads to the appropriations committee.

Given that the Colorado legislature is controlled by Democrats and the governor is a Democrat, there’s reason to be hopeful that this bill will pass. But that doesn’t mean hurdles are absent. That starts with the state’s budget, which must first be passed. Once legislators know how much money is available for new bills, they can consider proposed bills like HB 1218, which would require a budget of just over $500,000 a year.

Still, Rep. Brown is optimistic. The bill was the result, he said, of working very closely with a number of organizations, including American Atheists. It’s telling that no one testified in opposition to the bill when the committee met. Even the two people who voted against the bill didn’t offer any substantive reasons for their decision. How could they? This bill has solid ethical grounding.

Brown made clear that this was not by any means an anti-religious bill. This is about transparency, not religious persecution. If a faith-based hospital doesn’t want to offer certain services, nothing in this bill would require them to violate their religious beliefs. It merely asks them to tell the whole truth for the sake of their patients.

It’s long overdue and other states should imitate what Colorado is doing.

(Portions of this article were published earlier)