How much do health sharing ministries really help?

Due to ever-increasing costs of healthcare coverage, health sharing ministries were started throughout the U.S. more than two decades ago. But critics contend these ministries may have underlying disadvantages, according to U.S. News & World Report.

Another option for health insurance
As an alternative to traditional health insurance, health sharing ministries offer their members the chance to "share" the financial burden of medical bills. For some health sharing ministries, this means members will receive a letter every month about the cost of another member's medical bills. The member will then send the requested monetary amount directly to the member who is in need of medical care.

Through the Affordable Care Act, ministry members do not have to obey the law's individual mandate — meaning they're exempt from paying the penalty that comes with not having individual insurance.

According to the Alliance of Health Care Sharing Ministries, membership in health sharing plans has increased from 200,000 to 530,000 since the passage of the ACA in 2010.

Numerous health sharing organizations are based on Christian values, meaning their members must follow specific codes of conduct to remain part of the ministry. The rules of the code include regular church attendance, making a profession of faith and refraining from drunkenness, tobacco usage and sex outside marriage. When members need medical assistance because they disobeyed these rules, the plans do not cover the cost.

In some organizations, members can even vote on whether they think other members' medical care should be covered.

Skeptics voice their worries
In recent years, commissioners and judges in a number of states have attempted to shut down health sharing ministries, but their plans were thwarted when state lawmakers allowed the plans to continue to run.

Still, critics are concerned about the intentions of the plans. Rather than joining the plans due to religious reasons, Tim Jost, JD, professor of law at Lexington, Va.-based Washington and Lee University School of Law, is "concerned that you have people joining because they're trying to find cheap coverage or because they're ideologically opposed to the Affordable Care Act, or people who aren't committed," according to the report.

Others are worried about how these plans could affect the ACA exchanges. Because members of health sharing ministry plans are often healthier, the sicker people flock to the exchanges or Medicaid, according to Rachel Sachs, an academic fellow at Cambridge, Mass.-based Harvard Law School.

Past problems
Due to a lack of external regulation, it hasn't always been perfect for health sharing ministries. Although they're now required to complete annual audits performed by an independent firm, internal problems have crept in at health sharing ministries over the years.

A member of one organization, Medi-Share, needed heart-valve surgery after an infection. But Medi-Share wouldn't pay for it, claiming the heart condition was pre-existing. Medi-Share members subsequently filed a lawsuit.

In 2000, members of Christian Healthcare Ministries — formerly the Christian Brotherhood Newsletter — told the Ohio attorney general there were $34 million in unpaid claims. The organization's founder and his nephew were found guilty of civil and solicitation fraud, having used the extra donations to fund higher salaries, motorcycles and vacations.

A consensus?
Nevertheless, the ministries continue to succeed. Even internal supporters agree the ministries aren't for everyone. "Someone who isn't of the faith doesn't have a familiarity of the commands and requirements of the scripture," said Tony Meggs, president and CEO of Christian Care Ministry, according to the report. "We live our lives in a way that we share in each other's needs. That's a biblical mandate Christ gives us in scripture."

But many opponents still aren't convinced. "Getting together with a group of like-minded people sounds good and works well until it doesn't," said a spokesman from the National Association of Insurance Commissioners, according to the report. "You don't have any protections in terms of making sure your claims can be paid."

More articles on payer issues:
Highmark isn't the top insurer in Western Pa. anymore, UPMC analysis says
Who's eligible for Medicaid and CHIP? Kaiser Family Foundation takes a closer look
The problems aren't over at BCBS of NC

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