Federal Issue: Health Care Ministries Sharing Reform

Federal Issue: Health Care Sharing Ministries Reform

Health Care Sharing Ministries (HCSM) Reform

HCSMs are a form of non-compliant insurance-like or junk coverage in which members who typically share religious beliefs make monthly payments to cover healthcare expenses for themselves and other enrolled HCSM members. HCSMs are not considered insurance, so there is no guarantee that members’ claims will be paid even for expenses that meet membership guidelines for “covered services.” It goes without saying that abortion and contraception for most HCSMs are non-starters. Through a combination of a lax regulatory structures, selective payment of benefits, religious exemptions, and the high cost of health care, HCSMs have become extremely profitable.

Christian Healthcare Ministries reported $340 million in revenue in its 2017 tax filing. From 2015–17, Liberty HealthShare recorded a 900 percent increase in revenue, from $6.5 million to $65 million. The Alliance for Health Care Sharing Ministries, a national trade/advocacy organization that represents only a handful of HCSMs currently operating in the United States, estimates their member HCSMs have enrolled 1.5 million people nationwide, up from 130,000 in 1999.

Stories continue to emerge about how consumers are being duped into joining HCSMs, and numerous states such as California, Kentucky, New York, Maryland, Washington, New Hampshire, Colorado, Connecticut and Texas are taking action against HCSMs. Colorado has passed a law to curb some of HCSMs’ most egregious practices.

Legislation to curb these abuses supported by FFRF Action Fund includes:

Health Care Transparency Act

H.R. 8324, introduced Rep. Jared Huffman, Calif.

Protects consumers from the deceptive practices of Health Care Sharing Ministries (HCSMs). consumers from the deceptive practices of Health Care Sharing Ministries (HCSMs). Mandates that HCSMs can no longer hide their finances and activities and must annually disclose to the treasury secretary, IRS and Consumer Financial Protection Bureau the following information:

Their financial reserves.
Ratio of dollars collected for health sharing vs. actually spent on medical care.
Number of individuals enrolled.
Average out-of-pocket expenses per enrolled individual for items covered under the health share.
Service area of operation.
Percentage of claims denied.
Contact information for their leadership.
List of contracted healthcare providers and the average reimbursement time after using a healthcare service.
The government in turn would be required to publicly disclose online the responses from such ministries.

Empowers consumers by mandating that HCSMs disclose, in large and legible writing in multiple languages, and read aloud if enrolling over the phone, the following information:

How to file a complaint and appeal a denied claim.
Whether the HCSM forces arbitration in appealing a coverage determination.
Explicit explanation that the ministry is not required to pay claims.
Explicit explanation of any lifetime caps on total reimbursement.
Average amount paid per member to an HCSM annually.
Comparison of average paid for health services vs. shared amount.
List of all items and services deemed ineligible for reimbursement.
List of all requirements imposed on claims submitted for sharing.

Ensures that health insurance brokers selling ministry memberships must accurately describe the scope of benefits provided by the HCSM, and whether they are eligible for better, more comprehensive forms of health coverage, including the Affordable Care Act, Medicaid or Medicare. Plus, the Bill has an enforcement mechanism and penalty if the HCSM does not comply.