In February 2023, the Oregon Health Authority (OHA) became the first government agency in the US to review a hospital merger with the aim of protecting patients from the effects of a religious hospital monopoly.¹ At issue was the proposed acquisition of Mid-Columbia Medical Center (MCMC) by the religiously affiliated chain Adventist Health, which would have converted the only hospital in the county into a faith-based institution. During a period of public comment, citizens raised concerns that the closest secular hospital would be over an hour away and that the anticipated service limitations 鈥減osed threats to the rights of those who did not share the same faith.鈥�¹ The OHA eventually approved the merger conditional on Adventist continuing to offer existing MCMC services, including reproductive health care, gender-affirming care, and assisted suicide under Oregon鈥檚 Death with Dignity law, for 10 years after the transaction.²