State urged to delay decision on Caritas
Similar program in N.Y. has flaws, rights groups say
A plan by the Caritas Christi Health Care network to join forces with a nonreligious health organization that would cover abortions and other family planning services for low-income residents is now drawing fire from both sides of the political spectrum.
Several abortion rights and civil rights groups urged state regulators yesterday to postpone approving the proposal by Caritas, an affiliate of the Catholic Archdiocese of Boston, to offer insurance in the state's subsidized health program, called Commonwealth Care.
Advocates said they are concerned about hurdles that low-income women face in getting reproductive care after studying problems at a similar, though different, Catholic-affiliated managed care system in New York.
The criticism from abortion rights advocates followed calls over the weekend from abortion foes to abandon the deal, but on very different grounds. They said the Caritas venture is a betrayal of Catholic principles, a charge Caritas denies.
At the heart of the controversy is a proposed venture by Caritas and the
State regulators are scheduled to vote March 12 on whether to accept the Caritas-Centene bid, as well as four others by companies already providing coverage in the state's subsidized system.
Andrea Miller - executive director of NARAL Pro-Choice Massachusetts, an abortion rights group - said yesterday that her group looked at the experience of the Catholic-affiliated Fidelis Care system in New York and found that women seeking contraceptives or related services there often have to search to find a provider outside the Catholic-run system.
"The question is, can you actually obtain the care in a timely manner without having to go through a million hurdles and call six different places and go to four different locations," Miller said.
Caritas responded yesterday by saying they are unfamiliar with the New York arrangement but would look into it. To the earlier criticism leveled by abortion foes about abandoning Catholic principles, Caritas said abortions would not be conducted at Caritas hospitals and that they would hew to Catholic moral teaching.
Lois Uttley, director of the MergerWatch Project, a New York nonprofit that tracks religious-secular mergers, said a chief problem in New York is that women often are automatically enrolled in the Fidelis system if they do not choose another one, and then do not realize they will have to find other doctors for certain reproductive services.
"For low-income women who may have either limited literacy or limited English, it's difficult to understand how managed care works, and when you add a complication of having to go outside a provider network to obtain reproductive services, it can become just too complicated," Uttley said.
In Massachusetts, the Caritas-Centene bid was the lowest for most areas of the state, which means that, if regulators accept the proposal, the new venture would get the largest share of new enrollees unless they specifically requested one of the other four plans already participating in Commonwealth Care.
Fidelis Care spokesman Jayson White declined to comment on the New York issues.
Dick Powers - a spokesman for the Connector Authority, the Massachusetts agency that oversees the state's subsidized insurance program - said in an e-mailed statement: "The need for full coverage and adequate access is required for any plan to participate in the Commonwealth Care program." He declined to comment further.
Sarah Wunsch, staff lawyer for the American Civil Liberties Union of Massachusetts, said state regulators need to scrutinize these access issues before moving forward.
"Its great the Commonwealth has set up this subsidized healthcare system," she said, "But poor people are still entitled to adequate healthcare, and family planning and reproductive heath are part of that."
Kay Lazar can be reached at klazar@globe.com. 
