Caritas bids to join state network of health insurers
Concern arises over reproductive care
Thousands of low-income Massachusetts residents may be getting a new health insurance option this spring under a proposed venture by the Caritas Christi Health Care network and a St. Louis-based company,
State regulators yesterday unveiled the proposal as they reviewed bids to provide state-subsidized health insurance to 163,600 adults in the Commonwealth Care program.
It is the first time the Connector Authority board, which oversees the program, has opened the market to new companies since Massachusetts launched its pioneering health initiative in 2006.
At least one board member expressed concerns about the proposed Caritas-linked venture, called Commonwealth Family Health Plan, because Caritas, a six-hospital network affiliated with the Boston Archdiocese, does not perform abortions.
"How will our female members be provided these reproductive services?" said member Nancy Turnbull, an associate dean at the Harvard School of Public Health. "Those are not services Caritas provides."
In response, Caritas and Centene issued a joint statement late yesterday that said the new venture "will contract with providers, both in and out of the Caritas network, to ensure access to all services required by the authority, including confidential family planning services."
A spokeswoman for the companies declined to elaborate.
The new venture was the lowest bidder, which means that, if regulators accept the proposal, most enrollees in the subsidized program will automatically be assigned to the Caritas-Centene plan, unless they specifically request one of the other four plans.
About half the Commonwealth Care enrollees pay nothing for their coverage, while the rest pay a monthly premium based on how much they earn. Regulators will set new rates for monthly premiums at their March meeting.
Tentative numbers indicate that most enrollees will not see any increases and some may even have their monthly payment reduced slightly, officials said. That is in contrast to private insurance plans, with monthly premium increases of between 8 and 10 percent.
The Caritas-Centene proposal includes enticements for enrollees, such as a prepaid debit card that can be used to buy healthcare products.
The four other bidders also offered member enticements, such as reimbursements of up to $150 for acupuncture, message therapy, or joining a fitness facility. The other bidders, all already providing coverage in the state's subsidized system, are: Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Neighborhood Health Plan, and Network Health.
But much of the attention yesterday was on the joint venture pitched by Caritas.
Caritas is the second-largest healthcare system in New England, with more than 2,300 physicians providing services in historically underserved communities, according to the Connector Authority. Centene touts 25 years experience serving Medicaid populations, covering 1.2 million people in seven states: Georgia, Indiana, New Jersey, Ohio, Texas, South Carolina, and Wisconsin.
Regulators said they have scrutinized about half of Centene's operations nationwide and have found the company to be fiscally sound with strong management and not to be facing any lawsuits or negative government actions. They said the state's Division of Insurance will conduct an exacting review when Centene and Caritas apply for a license to operate in Massachusetts.
"If a plan is not ready in a service area or region, the state will not let them market their plan here," said Connector Authority chief financial officer Patrick Holland.
The authority board is scheduled to vote on the five bids March 12. Enrollment will begin in May, and coverage under the plans will start July 1.
Kay Lazar can be reached at klazar@globe.com. 
