July 1, 2009 Praise, criticism for O'Malley's Caritas handling Play video

(NECN: Greg Wayland, Boston, Mass.) - The health care controversy has been a test for Cardinal Sean O'Malley, earning him high praise and harsh criticism.

He oversees the Catholic identity of Boston's Catholic Hospitals, though not their day-to-day operation.

Now, with his approval, the six hospitals in the Caritas Christi system begin participation in a pioneering state-subsidized program for low income patients known as Commonwealth Care.

But only last Friday, O'Malley called on the Caritas board to withdraw from a joint venture with a Missouri-based insurer that offered abortion services through that program.

The proposal sent alarms through the national anti-abortion community. Now some anti-abortion activists are praising O'Malley.

"We do need to look at it further. But the pulling out from being involved in the organization that would be sponsoring abortions is a huge step," Anne Fox of Citizens For Life said.

For the financially troubled Caritas system, the joint venture may have amounted to an effort to save itself financially while expanding its services to the poor. But the Caritas board has declined to reveal financial details of the original proposal, or the existing state contract.

And as recently as March, the cardinal had used his blog to fire back at critics of the pending joint venture, saying Caritas would never promote abortions.

Catholic Action League Executive Director C.J. Doyle remains among

"Why did they seek this out? Why did they castigate critics? And why did they wait until just five days before the contract was due to be implemented to finally even begin to disengage?" Doyle asked.

Still at issue is a requirement for Caritas workers to make abortion referrals.

Under Catholic teaching, this can be seen as cooperation in an abortion.

And a board member for NARAL Pro-Choice of Massachusetts says they will be watching.

"Any time a woman signs up for primary care at a Caritas facility, she will have to have available to her for family planning or for reproductive health services another facility," Sam Perkins said. "We're the first state in the country to try to have universal health care and what NARAL would like to see happen is to make that work as seamlessly as possible with all of the providers who want to participate."

"If someone goes into a Catholic hospital looking for an abortion or sterilization or a contraceptive device, that hospital ought to be able to offer them a compassionate and ethical alternative," Doyle said.

Mass Citizens For Life president Anne Fox acknowledges that government-subsidized health coverage may come with regulations that challenge Catholic hospitals.

"Because we have conscience clause in this country and because we have the First Amendment, the hospital should be able to do what it feels is the right thing to do," Fox said.

And the controversy underscores the growing difficulty on the part of Catholic health care institutions across the nation to maintain their Catholic identity in the face of increasing pressure to provide services prohibited by Catholic teaching.