‘Obamacare’ alternative: health-sharing ministries offered a way out

Friend facing heart replacement surgery

https://www.gofundme.com/hoefling-family-medical-emergency

Tim and Jean Hoefling are well-loved residents of Louisville, CO. They are faithful Christians who served many years as missionaries and have been active members in their church community. Tim has always been a hardworking family man who has hardly known a day of ill health. Recently, he began to feel low on energy and unable to recover from what he thought was the flu. However, a few days ago he was admitted to the hospital because it was discovered that he has suffered two undiagnosed heart attacks, has a blood clot near his heart, and a systemic infection that cannot be identified. As of 3/25/19 he was air lifted to Anschutz where they have determined the best course of action is a heart transplant. The Hoeflings only have a health insurance co-op plan. The doctors will not move forward with the transplant until they are sure the money will be available to pay for it. They are looking at about $800,000.

As Sharing Health-Care Costs Takes Off, States Warn: It Isn’t Insurance - Religious organizations that provide an alternative to health insurance are growing rapidly but remain largely unregulated

Consumers typically pay a set monthly amount that goes into a general account or directly to others who have an eligible medical bill. They also submit their own eligible bills to be shared by other members.

As membership swells, more people have complained that their medical bills weren’t paid or were paid months late. Some states said they have seen an increase in complaints filed with regulators. More negative reviews have also appeared online.

Because the ministries aren’t regulated by state insurance commissioners, consumers have little recourse. Many legislatures have passed bills guarding the ministries from state regulation, on the grounds that the state shouldn’t interfere in a religious organization.

Sharing ministries say the uptick in complaints is negligible when compared against the surge in membership. They also say they tell members they aren’t buying insurance and that they have an appeals process for denied claims.

Unlike plans sold on the ACA exchanges, health-care sharing ministries have many limitations. Most don’t cover pre-existing conditions or preventive services such as checkups and mammograms. They don’t cover abortion and most birth control, and typically don’t share bills for mental-health services or addiction treatment. They may have limits on the total amount that will be paid for any treatment.

Millions of dollars are at stake. Among some of the largest ministries, Christian Healthcare Ministries, based in Barberton, Ohio, reported $340 million in revenue in its 2017 tax filing. Liberty HealthShare of Canton, Ohio, saw its total program revenue surge from $6.5 million in 2015 to $65 million in 2017. Samaritan Ministries International of Peoria, Ill., said its members shared $1.2 billion in health-care bills from 2007 through 2017.

Insurance regulators in several states have taken action.

The Nebraska Department of Insurance in 2018 warned that health-care sharing ministries aren’t insurance, aren’t regulated and can’t be forced to pay members’ medical bills.

I pay $1800/month for health insurance for my family but I could pay like $800/month if I did the health sharing plans. Here are the reasons I don’t:

1) It is not insurance. Insurance is supposed to cover emergencies. These plans have low caps that will not cover emergencies. For example, the cap on one of them is like $250K which would not cover a cancer diagnosis or heart disease. Who cares if you get $250K toward a $2 million medical bill? You still are likely to go bankrupt.

2) Because you pay out of pocket, you are at the mercy of the billing of the providers and while you can negotiate a bit, you cannot negotiate with the power of the big insurance companies. If you have real insurance, you only pay the negotiated rate, even if you have not met your deductible.That is a huge deal as I have found out.

3) There is just something weird about a health company telling me how much I need to go to church, how much I can drink, etc.

4) You have little recourse in disputes and you sign a statement saying that you won’t sue other Christians and if you sue them (the health sharing company), you get terminated. Very convenient for them.

5) I just don’t buy into the idea that Christian health care can be cheaper than non-Christian health care. Makes no sense. Look around and tell me that Christians are healthier than non-Christians. No way. No, they don’t cover abortion or a few other things but those things would make a negligible impact on cost. So something just seems off.

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