Bishop Anthony Taylor of the Little Rock Catholic diocese has expressed reservations about the acquisition of the QualChoice insurance company by Catholic Health Initiatives, which operates the St. Vincent Health System. The issue would appear to be insurance coverage of reproductive care.

An article in Arkansas Catholic quotes the Bishop as saying he’s had reservations since the beginning of discussions about whether the arrangement would “comply with Catholic moral teaching.” He said he believed the hospital company was operating in good faith. But, after discussions, he said:


“Having given this matter serious thought and prayer, I am not fully convinced by CHI’s reasoning that their acquisition of QualChoice will pose no moral or ethical conflicts.

“One of my duties as the bishop of the Diocese of Little Rock is to ensure that Catholic entities operating in Arkansas do so in a manner that is consistent with the fundamental moral teaching of the Catholic Church. Accordingly, I have submitted a formal Dubium (Latin for ‘doubt’) regarding this matter to the Vatican’s Congregation for the Doctrine of the Faith, which is the Vatican office that helps Pope Francis promote and safeguard Church doctrine on faith and morals.

“To my knowledge, that congregation has not previously addressed the moral and ethical issues presented by an acquisition such as this one. A Dubium is not a challenge, nor is it necessarily a negative response. Rather, it is expressing a ‘doubt’ regarding an unresolved issue, which is in need of clarification or resolution by the appropriate Vatican congregation.

The Times reported after the acquisition was announced that QualChoice said the acquisition did not mean its customers would lose coverage for reproductive care, which could include a number of services from contraception to medically necessary abortions. Even if those services were provided out of the St. Vincent network, they’d still be provided by a company owned by a Catholic institution, though through an affiliate, Collab. The company’s careful statement was that it would follow the law. Federal law requires coverage of contraception, for example, under terms of the Affordable Care Act. Purely religious institutions are challenging that requirement for plans that cover their own employees.

The bishop drew a distinction in this case and that of acquisition of the Mercy Hospital in Hot Springs by a private medical company, which he opposed because of medical services it would provide that run counter to church teaching. His opposition killed the deal and Mercy ultimately was acquired by St. Vincent. 


“The acquisition of QualChoice by CHI is very different than the proposed sale of Mercy Hospital Hot Springs to Capella Healthcare that I opposed by submitting a formal negative Votum (Latin for ‘opinion’) to the Vatican. In the current situation, CHI need not receive the same approval from a Vatican congregation to acquire QualChoice. Nevertheless, CHI obviously must operate in a manner consistent with fundamental Catholic moral teaching. My hope is that the Dubium I have submitted will bring clarification to an ethical issue that, in my opinion, has not yet been fully resolved with certainty.

“At this time my intention is to remain in dialogue with CHI as we await a response to my Dubium from the Vatican’s Congregation for the Doctrine of the Faith.”

Women insured by QualChoice, or who might consider QualChoice for insurance, perhaps will want to follow the discussion.

UPDATE: A spokesman for QualChoice tells me of the “fabulous news” that the QualChoice acquisition by an affiliate of CHI has been completed and will be announced today. It followed further meetings with the bishop and CHI. Statements are promised about both completion of the sale and implications for health services. I expect to receive shortly a statement in line with QualChoice’s earlier statement about health services under new ownership. Thus, I’m guessing, while QualChoice insurance might be required by law to cover reproductive services, it doesn’t mean they’ll be provided by a Catholic hospital.


QualChoice issued this statement about coverage:

“We don’t anticipate any changes to our benefit policies and procedures. QualChoice has always complied with applicable state and federal regulations requiring specific levels of benefits and that will not change. CHI’s mission is to create and nurture healthier communities. Through QualChoice, CHI expects to improve and expand access to affordable healthcare coverage, offering benefits and comprehensive care to more individuals in the markets we serve. CHI will be in a better position to extend health care services to individuals who now have no insurance, making care more affordable and accessible, especially to those who are less fortunate.

Neither QualChoice nor CHI interferes in medical appropriateness decisions between patients and physicians. To the extent federal and/or state governments mandate coverage for healthcare benefits, QualChoice is required to comply with those federal and state laws where applicable. To the extent mandated benefits conflict with the Catholic Ethical and Religious Directives, QualChoice will institute appropriate administrative practices consistent with the way other Catholic organizations have operated health plans and continue to do so within the Catholic moral tradition.”

A news release also was issued on completion of the deal. It follows.

CollabHealth, a wholly owned subsidiary of Catholic Health Initiatives, has closed on a series of stock-purchase agreements to acquire QualChoice Holdings, Inc. The Arkansas Insurance Department (AID) approved the acquisition during a hearing earlier this week.

Catholic Health Initiatives (CHI), one of the nation’s largest nonprofit health systems, operates St. Vincent Health System, which is based in Little Rock.

QualChoice Holdings, headquartered in Little Rock, is the parent company of QCA Health Plan, Inc., and QualChoice Life and Health Insurance Company, Inc. The transaction will provide Catholic Health Initiatives with control of QualChoice Holdings.

“This new ownership creates significant opportunities for QualChoice and is also very good for Arkansas,” said Mike Stock, CEO of QualChoice. “We are excited to now be an important part of Catholic Health Initiatives – it is a high-quality organization with a strong national presence.”

The transaction continues a longstanding partnership between CHI, St. Vincent Health System and QualChoice. St. Vincent has been a participant in the provider network of QCA Health Plan since its inception and an investor since 1999.

QualChoice Holdings, Inc., was organized in 2010 as a parent holding company following the acquisition of Community Bank Life and Health Insurance Company in 2009 and its restructuring as QualChoice Life and Health Insurance Company, Inc. QCA Health Plan is a health-maintenance organization created in 1996 and is licensed in all 75 Arkansas counties.

“We believe this is an important investment in the future of affordable health care options for the people of Arkansas,” said Juan Serrano, CHI’s senior vice president of payer strategy and operations. “CHI is committed to improving the health of communities, which is well-aligned with the objectives of QualChoice and the health-insurance operations we are developing across the country.”

No substantial changes in QualChoice operations or in provider network participation are anticipated by the change in ownership. “We are grateful to Commissioner Jay Bradford and his staff for all of their work in helping to make this transaction a reality,” said Mark Bjornson, CHI’s vice president, commercial and government health programs.