Caritas pulls out of insurance venture over abortion

By Michael Paulson, Globe Staff

Caritas Christi Health Care, the financially challenged Catholic hospital system founded by the Archdiocese of Boston, is abruptly ending its joint venture with a Missouri-based health insurer at the insistence of Cardinal Sean P. O'Malley, who has decided that the relationship represented too much of an entanglement between Catholic hospitals and abortion providers.

The dramatic development, just days before the joint venture was scheduled to start providing care to low-income residents as part of the state's efforts to establish near universal health coverage here, is a vindication of sorts for a variety of very conservative Catholic critics of the cardinal, who have been arguing angrily and loudly that it would be "evil" for Caritas to partner with a health provider that covers abortion services.

The development is also a setback for Caritas, because it represents the undoing of one of the most significant steps its new chief executive, Dr. Ralph de la Torre, had announced as part of his efforts to turn around the hospital system's finances. It was not immediately clear last night what the financial impact of the change is on Caritas, but the decision is a stark and public reminder from O'Malley to de la Torre and the general public that moral concerns will trump monetary concerns at the Catholic hospitals.

The change will have no effect on patient care, because Centene Corp., the Missouri-based insurer, will continue to participate in the state-subsidized program, called Commonwealth Care, starting Wednesday.

And Caritas will continue to participate in the program, but now simply as one of many health care providers hired by Centene to treat patients. Caritas's role as a provider will be the same as the role it plays when providing care to people covered by private insurers such as Blue Cross.

In keeping with the ethical directives that bind Catholic hospitals, Caritas hospitals will not provide abortion or sterilizations. Caritas already refers privately-insured patients who seek such services to their insurance providers, and will do the same with state-insured patients.

Here is a statement from Richard Lynch, the chief executive of CeltiCare Health Plan of Massachusetts, the former joint venture, which is now solely owned by a Centene subsiary:

"Effective today, Caritas has withdrawn their ownership position in CeltiCare Health Plan of Massachusetts. Celtic Group Inc. (a wholly-owned subsidiary of Centene Corporation) now owns 100% of the company. Caritas Christi will continue to participate as a key part of the CeltiCare provider network. The arrangement in no way affects the operations of CeltiCare Health, and we look forward to delivering quality health care services to our members starting on July 1st."

And here is a joint statement from the Archdiocese and Caritas announcing the development minutes ago:

"Based on the decision of the Caritas Christi Executive Committee of the Board of Governor's to relinquish its membership and equity interest in the previously established joint venture, CeltiCare Health Plan Holdings, LLC (formerly known as Commonwealth Family Health Plan Holdings, LLC) but maintain its important role as a provider of health care to many enrolled in the state's Connector Program, the Archdiocese of Boston today expressed support for the new arrangement.

Cardinal Seán P. O'Malley said, "I am pleased that Caritas Christi was able to achieve this outcome. Throughout this process, our singular goal has been to provide for the needs of the poor and underserved in a manner that is fully and completely in accord with Catholic moral teaching. By withdrawing from the joint venture and serving the poor as a provider in the Connector, upholding Catholic moral teaching at all times, they are able to carry forward the critical mission of Catholic health care."

Caritas Christi CEO Dr. Ralph de la Torre said, "The opportunity for Caritas Christi to participate in the Connector program will allow Caritas to serve the low income and underserved population's desperate need for quality health care. We are committed to fulfilling our mission, as we always have, rooted in the principles established by Catholic teaching, of providing the highest quality healthcare to patients across the Commonwealth of Massachusetts."

Expansion of Caritas' care for the poor and the uninsured was the original motivating force in entering the agreement with Celtic Group, Inc. (a subsidiary of Centene Corporation). Catholic health care in the United States has two principal goals: providing health care for all, a basic requirement of social justice; and protecting the sacredness of human life from conception until natural death. The protection of human life and dignity demands that Catholic institutions never contribute to procedures which are inconsistent with Catholic moral teaching, such as abortion and sterilization. These procedures and others are prohibited by the Ethical and Religious Directives of the United States Conference of Catholic Bishops.

Having withdrawn from the original joint venture, the provider agreement will allow Caritas Christi to fulfill its mission of serving the poor without participation or cooperation in procedures forbidden by the moral teaching of the Catholic Church.

The decision to withdraw from the joint venture follows several weeks of discussions between Caritas and Centene and an extensive analysis by the National Catholic Bioethics Center (NCBC) which was undertaken at the request of the Cardinal. Over that time, subsequent discussions involving Caritas Christi, the NCBC and the Archdiocese were held and the Cardinal made his final determination. The Cardinal's role in reviewing and seeking additional guidance on this proposal is rooted in his responsibility to ensure the Catholic identity and moral character of institutions affiliated with the Archdiocese of Boston, including Caritas Christi.

"The goal of this review was to ensure that Caritas Christi could serve the poor through a plan for participation in the Connector that is in complete accordance with Catholic moral teaching," said Cardinal O'Malley. "I want to thank Dr. Ralph de la Torre and his team at Caritas Christi and the NCBC for their thoughtful collaboration. I also want to extend my sincere gratitude to Dr. John Haas and the staff at the National Catholic Bioethics Center for their diligent and comprehensive review of the proposal. I am pleased that they were able to provide a recommendation whereby Caritas can go forward in fulfilling its mission of Catholic healthcare."