Cardinal Sean P. O’Malley, concerned about the relationship between Caritas Christi Health Care and an insurance plan that covers abortions, is seeking modifications to the joint venture that the beleaguered Catholic hospital chain has entered into with a St. Louis-based healthcare company to provide insurance to low-income Massachusetts residents.
O’Malley, who has been criticized by several conservative Catholic and antiabortion activists for his handling of the Caritas venture, issued a statement yesterday declaring that "under no circumstances" will Caritas provide or refer patients for procedures prohibited by Catholic teaching, which include abortion, contraception, and sterilization.
And the Archdiocese of Boston said publicly for the first time yesterday that Caritas would not be permitted to profit from the provision of abortion services by others.
The archdiocese would not specify the changes it is seeking to the joint venture, called CeltiCare, which is 49 percent owned by Caritas Christi.
But the church sought to clarify its requirements for the deal after a number of conservative bloggers and interest groups had recently criticized the venture, accusing O’Malley, often in quite angry language, of abandoning the church’s commitment to protecting the unborn.
This week, many of the activists have seized upon, as evidence of the problematic nature of the venture, the new website of CeltiCare. The website specifies the copayments for abortions (from 0 to $100, depending on the plan), and lists family planning and reproductive service providers, including Planned Parenthood facilities in Boston, Somerville, and Worcester.
The president of Caritas Christi, Dr. Ralph de la Torre, issued a statement yesterday saying that individuals covered under the new venture will be told to talk to their insurance company if they seek abortions or other services prohibited by Catholic teaching.
"When a patient seeks such a procedure, Caritas healthcare professionals will be clear that (a) the hospital does not perform them and (b) the patient must turn to his or her insurer for further guidance," de la Torre said. "This, in fact, is the practice currently in place in the Caritas system as we work with other insurance companies under state laws that mandate access to procedures not provided within the Caritas system."
The joint venture, with Centene Corp. of St. Louis, will provide health insurance to thousands of low-income residents of Massachusetts under the Commonwealth Care program, a state-subsidized health insurance program for the working poor. The companies have said that CeltiCare is 51 percent owned by a subsidiary of Centene and 49 percent owned by Caritas Christi, which is incorporated independently from the archdiocese but has a Catholic identity overseen by the archbishop of Boston.
The hospitals are facing time pressure to resolve the cardinal’s concerns, because CeltiCare has already begun enrolling low-income people and is supposed to begin providing them with health insurance coverage July 1. Neither the state Connector Authority, which oversees Commonwealth Care, nor CeltiCare would say how many residents have signed up for coverage.
The archdiocese said it is optimistic that Caritas will be able to renegotiate its arrangement with Centene in a way that will be acceptable to the cardinal, who is obligated under church law to ensure that Catholic hospitals in the archdiocese comply with Catholic healthcare ethics.
- PDF Cardinal, Caritas Christi reaffirm commitments
- 3/13/09 Mass. regulators OK joint Caritas-Centene healthcare venture
The cardinal is eager to find a way to make the venture work, because it will serve the poor, which is a priority of the church, and because it will help the Caritas chain, which has had financial problems.But the archdiocese said that the cardinal cannot compromise on the church’s ethical directives for Catholic hospitals and that if the final deal does not comply with his understanding of those directives, he will be obligated to block the venture.
The archdiocese would not say yesterday whether the ownership structure of CeltiCare would change, but a statement from the archdiocese and Caritas said, "Caritas is in active discussions with Celtic Group [a Centene subsidiary] and CeltiCare with a view to making acceptable modifications to their arrangement." Centene referred questions to CeltiCare, and its spokesman said he had no comment.
Some of the cardinal’s critics are applying a tougher standard to the deal than are many moral theologians and Catholic healthcare officials, who have said that the issue here is whether Caritas is "cooperating with the evil of abortion."
Judie Brown, president of the American Life League, an antiabortion organization, said she does not believe there is any way to modify the arrangement that would make it acceptable.
"Caritas Christi has been put in a position of having to align itself with a provider that does provide abortions, contraception, and sterilization, and it would be crippling to the Catholic identity of Caritas Christi, and therefore the credibility of the archdiocese, if this agreement were to go forward in any way," Brown said.
Brown said she believes the Caritas arrangement is not unusual among Catholic hospitals, and said, "This is a scandal throughout the church."
Brian Delaney, a spokesman for CeltiCare, said an abortion rights group, NARAL Pro-Choice of Massachusetts, will serve on an advisory group for the health plan but he did not know whether any Catholic groups would be on the panel.
Andrea Miller, NARAL executive director, said of the possible modifications to the venture: "The real question is how this plays out in the real world. If it turns out this process of refusing to provide even referrals and sending patients back to health plans creates a barrier to low- or lower-income people obtaining care that they need and have a right to, we will have to . . . ask some hard questions."