SEATTLE - Almost half the hospital beds in Washington are now part of faith-based healthcare systems, up from one-in-four just four years ago. Some believe the trend could limit the types of care available to patients, and they're speaking out about it.

Those affiliations include Vancouver-based PeaceHealth uniting with the University of Washington, and the new Spokane Teaching Health Center's alliance with Providence Health Care.

Leah Rutman, policy counsel with the American Civil Liberties Union of Washington, says they will be watching to see how closely the secular partners in these mergers are affected by the Catholic Ethical and Religious Directives for healthcare.

"These directives do state these Catholic healthcare systems are not allowed to provide many fertility treatments, reproductive health services, and end-of life services," says Rutman. "So, those all are very real concerns. How each individual hospital or health system interprets these directives may be different."

The organizations involved in the mergers have said patient care won't be compromised. Rutman points out, public dollars fund some of the patient care at the hospitals and affiliated clinics and she notes the Washington state Constitution says "no public money shall be appropriated for...the support of any religious establishment."

End-of-life care and Washington's "Death with Dignity" law are at issue for the group Compassion & Choices. Executive Director Robb Miller says the law allows religious organizations to opt out. His fear is medical professionals and social workers won't make referrals outside their system, or give people information that doesn't line up with the religious directives.

"Informed consent is one of the most important principles in the practice of medicine," says Miller. "It's the withholding of information and referrals that is really the issue with these providers."

Medical and graduate students at both universities also have voiced concerns about training or residency restrictions that might arise from the religious directives. Miller says the best way people can find out about care restrictions is to ask their doctor or hospital.


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North Dakota's June 11 primary is inching closer and those running for legislative seats are trying to win over voters, including Native American candidates who are part of a movement energized by newly drawn political boundaries.

The organization North Dakota Native Vote said there are seven candidates with Indigenous roots seeking spots in the Legislature. Most are running in District 9, which was recently updated to reflect representation needs for two Native American tribes.

Natasha Gourd, a board member of North Dakota Native Vote, described them as a good mixture of candidates coming from both reservations in the area, with some running as Democrats and others as Republicans.

"We've seen an upturn in participation and just getting leadership development through Native candidates," Gourd observed.

The election wave comes after the state saw 10 Native candidates in legislative races two years ago. For her group, Gourd acknowledged the boost can be tricky because they cannot endorse everyone running. But she noted having greater assurances the areas will be represented by people from their community -- no matter if they have a different stance on certain issues -- is still a positive.

Gourd added trying to build on the momentum is also important for off-reservation districts.

"What they do at the state level, regardless of Native American people in North Dakota (being part of) federally recognized tribes, it does affect us," Gourd pointed out. "Most Natives in North Dakota do live off the reservation, so it does affect our populations."

Gourd stressed they need more Native voices at the state level speaking out about priorities within education, the housing crisis, energy issues and health care. She hopes the positive trends they're seeing inspire more civic participation among other racial and ethnic groups trying to get a seat at the policy table in North Dakota.

A new poll finds a near 20-year low in the number of voters who say they have a high interest in the 2024 election, with a majority saying they hold negative views of both President Joe Biden and former President Donald Trump. A group of Arizona elections officials and experts recently gathered to discuss the growing discontent with the state's current electoral landscape.

Stephen Richer, Maricopa County Recorder, said that if politicians are what he calls "single-minded seekers of re-election," he contends the state should change the political incentive structure.

"And if those incentives will change, then maybe we will be talking about more things in the Arizona Voter's Agenda and less things that are currently right now incentivized by what I still believe to be a minority, but a very passionate, very loud, and a minority that is definitely committed to acting on those issues," he said.

Richer added it is important to remember that despite Independent and unaffiliated voters being able to participate in the July 30th statewide primary, they were excluded from the state's March Presidential Preference Election, and that has caught the eye of some in the state. The bipartisan group Make Elections Fair Arizona is pushing for open primaries, but proponents of closed primaries believe they're crucial to maintaining the integrity of party ideals.

Amanda Burke, executive vice president with the non-partisan, nonprofit organization Center for the Future of Arizona, said more than half of unaffiliated voters do not feel they have leaders or candidates running who speak to the issues and causes they care about. She contends that then translates to who decides to show up at the ballot box and vote, and encourages Arizonans to imagine a different primary system if they want different outcomes.

"Otherwise we are going to continue to have some more outcomes in terms of people who are incentivized to speak to a small percentage of their base on either side who are really not representative of the larger views," she explained.

The Grand Canyon State allows voter-initiated amendments to the state constitution, but the Arizona Require Partisan Primary Elections Amendment would add the state's current primary practice to the state constitution, prohibiting future changes without another constitutional amendment. Make Elections Fair Arizona is still collecting signatures to get its measure on the November ballot.


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Wisconsin women have made progress in closing gaps when it comes to being elected to public office.

But some voices worry the movement might slow down as candidates see increasing levels of threats and harassment.

The Brennan Center for Justice recently issued findings that detail the threatening behavior those in the political arena are experiencing now.

Women were three to four times as likely as men to experience abuse targeting their gender.

Erin Vilardi, CEO and founder of the advocacy and assistance group Vote Run Lead, said this creates more unfairness in areas such as resource planning for a campaign.

"We see women candidates and incumbents right now having to pay for security," said Vilardi, "having to put in their budgets, in their campaign funds, in their line-items for their campaigns a security detail."

And Vilardi said because of the worsening climate, the threats are extending to almost all other candidates, including conservative white men.

She and other researchers called on party leaders to strongly condemn political violence. They also recommend that each state implement stronger protection for officeholders.

Vilardi said it's not just women candidates and incumbents having to deal with this behavior. Women working as top aides and political journalists are subject to more hateful rhetoric these days.

"This is something that permeates women in politics," said Vilardi, "not just for the folks that are stepping up to lead but for the ecosystem of women around them."

And if more women decide not to run or seek re-election as a result, Vilardi said this means there will be fewer opportunities for gender equality in leadership positions in state legislatures and Congress.

She urged constituents to send messages of support to women officeholders as they weigh these challenges and their political futures.

Support for this reporting was provided by the Carnegie Corporation of New York.



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