Roe v. Wade ruling to have 'practical' impact on hospitals, AHA says

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The American Hospital Association's reaction to Friday's Roe v. Wade decision overturning close to 50 years of abortion rights was brief and lacking the emotion of other statements by health leaders.

Department of Health and Human Services Secretary Xavier Becerra called the decision "unconscionable," with abortion being a basic and essential part of healthcare.

The American Medical Association condemned the court's interpretation. AMA President Dr. Jack Resneck said, "The American Medical Association is deeply disturbed by the U.S. Supreme Court's decision to overturn nearly a half century of precedent protecting patients' right to critical reproductive healthcare – representing an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients' rights to evidence-based reproductive health services."        

The American Hospital Association said it expects the decision will have "practical impacts on hospitals and health systems," AHA General Counsel Melinda Hatton said by statement.

These impacts include, Hatton said, providing healthcare across state lines; Emergency Medical Treatment and Labor Act obligations; maternal healthcare; the clinician-patient relationship; medical education; and access to care for individuals, regardless of socioeconomic status.

"We are committed to helping our member hospitals and health systems navigate the evolving landscape consistent with AHA's mission of advancing the health of all individuals and communities," Hatton said.

Many spoke of the ruling's affect in widening racial and equity issues.

Northwell Health, which is among New York State's largest health systems, said, "Our concern as the region's largest healthcare provider is that this ruling will succeed in ending access to safe abortions and disproportionately cause harm to those who already have limited access to healthcare." 

Johns Hopkins Center for Communication Programs Interim Director Bill Glass said of Friday's ruling: "That one act ushers in a public health crisis that had been unimaginable in my lifetime. We know that women will suffer because of this, will lose the chance to advance themselves in our society because of this, will die because of this. It makes saying goodbye to my 18-year-old daughter that much harder as she leaves for college in a matter of weeks and is thrust into a world where half of the population is no longer trusted to take care of themselves."

United States Surgeon General Dr. Vivek Murthy said, "When reproductive health decisions are restricted, the number of unplanned pregnancies and unsafe abortions rises. Ultimately, the health of women and pregnant people is put at risk – an effect that will be felt disproportionately in historically marginalized populations, including communities of color, low-income Americans, and rural residents. Healthcare providers, who are already under extraordinary strains due to the pandemic, will be forced into an impossible choice between doing what's right for their patients and complying with laws that are at odds with their patients' health interests."  

WHY THIS MATTERS

The ruling leaves decisions about abortions up to the states. An estimated half of the states either have laws already in place or are expected to enact restrictions to abortion access.

The ruling raises questions of accessing an abortion across state lines; ordering abortion pills by mail; and any potential liability on the part of physicians, especially those treating patients in the emergency room.
 
"While some states have already taken action to preserve reproductive health rights, in many others, today's decision means that the reproductive health protections many Americans have relied on have now already disappeared or will soon be gone," Murthy said.

Northwell said New York State already has laws that establish a woman's right to an abortion and offers protections for healthcare providers in the state who perform this procedure legally. 

The AMA's Resneck said, "Today's opinion shifting reproductive health decision-making to lawmakers opens a deep political rift between states over access to reproductive health services that places sound medical practice and the health of patients at risk. … Access to legal reproductive care will be limited to those with the sufficient resources, circumstances, and financial means to do so – exacerbating health inequities by placing the heaviest burden on patients from Black, Latinx, Indigenous, low-income, rural, and other historically disadvantaged communities who already face numerous structural and systemic barriers to accessing healthcare."

Dr. Bruce Siegel, president and CEO, America's Essential Hospitals, said, "We are concerned about how today's U.S. Supreme Court decision might affect access to care and maternal health, especially among low-income and marginalized people, and the ability of providers to deliver care without fear of possible criminalization.

"But this decision could inspire policies that result in an uneven distribution of providers across states, greater disparities in maternal health, and conflicts between state and federal laws. For example, providers might face concerns about how to reconcile state restrictions with their obligations under federal law to stabilize and treat emergency department patients. A chilling effect on physician training and shortages of obstetrician-gynecologists in some states also could follow this ruling."

THE LARGER TREND

President Joe Biden on Friday called the Supreme Court decision that overturned Roe v. Wade a "sad day for the court and for the country" and called on Congress to restore abortion rights protections.

"Now with Roe gone, let's be very clear: The health and life of women of this nation are now at risk," he stated, speaking from the White House. He called it, "a tragic error by the Supreme Court," according to Politico.

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org