Legislation could put mission of Catholic hospitals at risk

Catholic hospitals in Indiana could face challenges in fully carrying out their mission, including providing care for the poor and vulnerable, if legislation moves forward that could potentially strip them of their non-profit status.  

The Indiana Catholic Conference (ICC) is closely following legislation at the Statehouse aimed at easing health care costs for patients – a goal that the Catholic Church shares – while also working to ensure that Catholic hospitals can continue to fulfill the Christ-centered care that has always defined them. Of particular concern is House Bill 1004, which would deny hospitals their tax-exempt status if they charge above certain Medicare reimbursement rates. 

“Ultimately, our engagement with House Bill 1004 and other health care bills is focused on helping our Catholic health care systems remain rooted in their Catholic identity while providing exceptional care for the whole person,” said Roarke LaCoursiere, associate director of the ICC, the public policy voice of the Catholic Church in Indiana.  

The ICC, which speaks on public policy issues on behalf of the five Catholic bishops of Indiana, has shared with lawmakers the principles that guide the state’s Catholic health care institutions along with their counterparts nationwide. These principles are outlined in the Ethical and Religious Directives (ERDs) for Catholic Health Care Services, written and published by the U.S. Conference of Catholic Bishops.  

The ERDs, which are derived from centuries of Catholic theology and social teaching, encompass a multitude of principles and policies that promote a Catholic health care institution’s “commitment to human dignity and the common good.” They include calling for generous care for the poor and the most vulnerable in society, along with a comprehensive program of pastoral and spiritual care for all patients.  

“The bishops’ main concern is that our Catholic health systems should be able to maintain their Christ-centered approach to health care,” said Alexander Mingus, executive director of the ICC. “Catholic health care clearly contributes to the common good. Additionally, we see how our Catholic health systems are demonstrating a desire to be attentive to the high cost of health care and their commitment to be leaders in price transparency, quality care for the whole person, and accessible care all across Indiana.” 

The largest Catholic health care networks statewide are Ascension St. Vincent and Franciscan Health. Along with Trinity Health, a Catholic network with a presence in northern Indiana, hospitals run by these organizations could lose their non-profit status if House Bill 1004 becomes law and therefore potentially compromise their ability to practice according to their Catholic values. 

House Bill 1004, which is currently awaiting further action in the Senate Appropriations Committee, passed the Indiana House in late February on a 68-26 vote. Among other provisions, the measure would strip a hospital of its tax-exempt status if it charges more than 300 percent of Medicare rates for a given service.  

Representatives of Ascension St. Vincent point out that because Medicare reimbursement rates are often far below what is required to complete necessary services for a patient, the ability for Catholic hospitals to carry out their mission – especially in providing care for those who cannot afford it – could be placed in serious jeopardy.  

“Our main concern is that if our not-for-profit status is revoked, our commitment to our mission, which is rooted in the loving ministry of Jesus’ Gospel values, is going to be inhibited in a way that will not allow us to serve the needs of our communities at large,” said Loraine Brown, chief mission integration officer at Ascension St. Vincent, whose statewide network includes Ascension St. Vincent Hospital in Indianapolis.  

Brown said that last year alone, Ascension St. Vincent provided $358 million in charity care and community benefits to those in need statewide. In addition to its 19 hospitals, Ascension St. Vincent in Indiana operates more than 300 clinics and doctor’s offices, along with seven smaller hospitals of under 25 beds that serve people in small rural communities.  

Community health access workers with Ascension St. Vincent assist people around the state with a wide variety of services every day in keeping with Catholic values and following the results of Ascension’s regular community needs assessments, according to Brown. Among the top needs, she said, are access to health care, maternal and fetal health concerns, and behavioral health.  

“Our health access workers are embedded in each of our hospitals, and they help patients and community members connect to resources,” said Brown, a member of St. Malachy Catholic Church in Brownsburg. “If they don’t have insurance, we help them sign up for it. If they need transportation to a doctor’s appointment, we set that up and help cover that cost.” 

In addition, Brown pointed to her organization’s efforts to improve maternal and fetal health in Indiana, along with its commitment to healthy babies and children. She said mothers in need frequently receive help for necessities ranging from diapers to car seats, all to “ease the burden” for the most vulnerable mothers and families.  

“We are a Catholic ministry, just like every Catholic parish in Indiana is a ministry of the Church,” Brown said. “We want to continue to care for the poor and vulnerable and to the continue the legacy of our founding religious congregations.” 

At the same time, she added, lowering health care costs “is as important to us as it is to the legislators.”  

“Stewardship is a Catholic social teaching principle, and we always want to be good stewards of our resources,” Brown said. “We work on being as creative as possible so that we can provide the highest level of quality health care at the most reasonable cost.” 

As the fate of House Bill 1004 remains unclear, Brown said her ultimate hope is that Catholic health care institutions in Indiana can continue their “outreach to the communities that are in need of healing.” 

In a recent ICC podcast, Mingus discussed the Church’s centuries-old commitment to healing, begun by Christ himself.  

“As everything does, it all points back to Christ,” Mingus said. “Christ the Divine Physician is our model for health care. Christ inspired the early Christians to set up networks of charity, which were really the first hospitals, as an expression of the Church’s ministry. That’s the root of Catholic health care.  

“Our hope today is that this same core mission exists within all of our Catholic health care entities in Indiana and beyond.”