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Health care sharing ministries

schmidt

I listen to the radio when I’m working on that garage I’m building down the hill. Can’t hear it above the saw but it keeps me company. When I heard the ad for a “Health Care Sharing Ministry” I listened carefully, because I know what they are; and what they are not. But the ad sure didn’t help me know that.

Most HCSMs allow membership if applicants share the same religious beliefs. Some only ask that you have a “healthy lifestyle”. You are expected to pay a monthly fee, then when you have a medical cost, you apply for reimbursement.

I got my introduction to these when a fellow State Senator brought a bill before my committee back in the anti-Obamacare days. I’d never heard of them before. It turns out the ACA included an exception for these; folks so enrolled didn’t have to pay the Individual Mandate penalty. But the Obama compromise also limited these entities to ones in place before the year 2000. And that individual mandate penalty is now $0.

Back when the ACA compromises were being handed out, there were only about 100,000 people enrolled in these. Small potatoes to the insurance industry, and Obama, the great compromiser, thought this was a practice worth defending, so folks who participated got written out of the requirement for the Individual Mandate.

The bill before us that got me studying “just wanted to make sure” Idaho didn’t treat these entities like insurance. And they aren’t. But that radio ad I heard last week sure made them sound like it.

“Health insurance unaffordable? Try us!” was basically what it said.
Nowadays, HCSMs have over a million participants nationwide. And I guess radio ads are part of their marketing plan.

Remember, we (that is, Congress) have been doing nothing for the last ten years to keep health insurance affordable. I can see why folks are looking for a low-cost alternative. But HCSMs are not insurance.

Health insurance companies are regulated, both at the federal and state level. Health insurance companies cannot exclude you for a preexisting condition (thanks to the ACA). HCSMs can. Health insurance companies cannot kick you off for getting sick (expensive), also thanks to the ACA. HCSMs can. Health insurance companies must spend 80% of their revenue paying for health care (thanks ACA). And they get audited. HCSMs have no such obligation for transparency.

When I first heard about these long ago in committee, I thought they sounded like an informal mutual aid society, with a scriptural inspiration. The Apostle Paul said, “Bear one another’s burdens, and thus fulfill the law of Christ.” Galatians, Chapter 2 Verse 6. Why not let like-minded folks pool their resources and care for each other? My question is, why do they need to advertise on the radio?

It seems that some Idaho legislators might listen to these radio ads in their neck of the woods too. A bill was attempted to be introduced back in February to put some regulations on these actors. It was interesting to me that a Republican legislator carried it, and the committee rejected it. Now, as an Idaho Democrat, that’s familiar territory, but a Republican sponsor, and a member of the committee? He must have had a real stinker.

Oh, that’s right, it had to do with regulations. We don’t need no regulations.

But another bill was introduced and printed, so we can read the suggestions. It is in a chairman’s drawer.

The bill proposes HCSMs have an annual audit that is made public, not exclude anyone based on their health risk, and not misrepresent itself as insurance.

I doubt the Idaho legislature will want to support such brazen regulations. We all just need to be careful when we are buying stuff, don’t we? We’re on our own here folks.
 

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