Are Catholic hospitals and universities really in danger of closing?

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Chicago's Cardinal Francis George caused a stir last week when he wrote that Catholic-affiliated institutions are in danger of closing as a result of the Department of Health and Human Services' requirement of mandatory contraception coverage.

"If you haven’t already purchased the Archdiocesan Directory for 2012, I would suggest you get one as a souvenir," George wrote in his column for archdiocesan newspaper Catholic New World. "On page L-3, there is a complete list of Catholic hospitals and health care institutions in Cook and Lake counties... Two Lents from now, unless something changes, that page will be blank."

George's comments left some to speculate on the disaster of Catholic hospitals closing their doors, but less attention has been paid to a more obvious question: Do the bishops have the authority to shut down Catholic hospitals, universities, and social service agencies? And if not, do the institutions themselves feel strongly enough about this to close over the law?

The answer, most likely, is no on both counts. Most of these organizations are run not by a diocese, but by either a religious order, an independent board of directors, or some combination of the two. Though they have a Catholic mission and may follow the teachings of the church, they are generally not answering directly to their local bishop.

Many Catholic hospitals are run by larger healthcare networks, like Resurrection Health Care in Chicago or Catholic Health East, which are sponsored by multiple religious communities (and which have not themselves come out against the mandate). A good example of a bishop's authority over a Catholic hospital is the case in Phoenix that saw Bishop Thomas Olmsted strip St. Joseph's Hospital of its Catholic identity when the hospital approved an abortion to save the life of the mother. The hospital didn't close, nor did it change its name or break ties with its healthcare network, Catholic Healthcare West (which has since changed its name to Dignity Health). More importantly, St. Joseph's still maintains the same Catholic mission and values it has always had and it still follows the Ethical and Religious Directives for Catholic hospitals.

Catholic universities are in a similar situation, as most have been established by a religious order. A recent report by the National Women's Law Center found that a number of Catholic universities already offer some form of contraceptive coverage to employees. The University of Dayton, a Marianist university in Ohio, announced that it has had health insurance coverage of contraceptives for 20 years and has no plans to change the coverage it offers employees. The Association of Jesuit Colleges and Universities, which oversees 28 Catholic institutions in the United States, issued a statement saying they are satisfied with the president's accommodation on the mandate. Not all Catholic colleges and universities are happy, but it doesn't sound like we're in danger of massive closings.

That just leaves social service agencies, which are in most cases also incorporated separately from a diocese. In Chicago, for example, Catholic Charities is a separate 501(c)(3) organization, which raises funds separately from the archdiocese and receives the largest share of its income from government agencies. And what would happen if such a group were placed at odds with church teaching? A recent example can be found elsewhere in Illinois, where the Diocese of Belleville's social service arm ended its Catholic affiliation over a state law that would require state-contracted adoption and foster care services to place children with same-sex couples. The organization changed its name from Catholic Social Services to Christian Social Services of Southern Illinois and no longer has a direct link to the diocese, but they do maintain the same mission and values. And they still provide a range of programs to help people in need.

Hopefully no organization will be forced to shed its Catholic affiliation or be disowned by a local bishop over the government's health care insurance regulations. But those that do choose to follow the law, even against a bishop's wishes, won't necessarily abandon their Catholic mission. And even though bishops may threaten that the law will mean those institutions will be wiped from the pages of diocesan directories, that doesn't mean the organizations themselves will cease to exist.