With health insurance rates rising out of the reach of many and Affordable Health Care Act (ACA) co-ops dropping like flies, some are turning to faith-based healthcare sharing ministries as an alternative. But legislators and brokers are warning that consumers may be leaving themselves uncovered.
When the ACA was passed into law in 2010, Congress determined that Healthcare Sharing Ministries established prior to December 31, 1999 could be exempted from the law’s requirement of individually mandated health coverage.
Essentially, these faith-based organizations set an amount that individuals, couples, or families pay each month. That amount is then matched to another member’s medical bills for approved expenses.
But the caveat is that the organization facilitating the sharing of medical expenses is not an insurance company and there is no guarantee of payment.
Yet the organizations appear to be growing in popularity. Insurance Commissioner for Wyoming, Tom Glause, said last week that there are currently an estimated 425,000 member organizations —double the number prior to the passing of the ACA.
“These plans have a lot of appeal for some people, but we want Wyomingites to be fully aware of what they are getting. Assistance with medical bills is completely voluntary and no other participant in the group is compelled by law or otherwise to contribute toward your medical bills,” Glause said.
As of yet, the ministries don't appear to have made an impact on more traditional healthcare plans. A spokesman for eHealthInsurance, a broker serving some three million customers in the US, said “it's not something we're seeing have any effect on a macro level.” But he added this isn't surprising as the ministries “don't offer the same benefits as the ACA”.
Moreover, with the ministries being free of certain restrictions they can impose maximum benefit amounts and screen members for pre-existing conditions to help manage costs. It's typical for members to agree to a common set of ethical or religious beliefs and as a result some procedures, treatments, and products may not be included. Many require members to prove they are active in a Christian church and have a pastor or clergy sign off on an application form, for example. And members often must indicate they don’t smoke, do drugs, drink alcohol, or have sex outside of marriage. Dental, vision, and contraception are also often not included.
But the traditional market is shrinking, if only a little. Wyoming's ACA-enabled health co-op, WINhealth Partners, announced it was closing down in October, leaving tens of thousands weighing the alternatives.
“Sure it's unfortunate that there's less choice,” said the eHealthInsurance spokesman, “but the percentage of plans in total is only down about 5%,” he said.
At present, the online reviews seem favorable, with the ministries performing as claimed, but there are dissenting voices appearing on forums, hinting at problems associated with growth.
“In the first year or so, my needs were meet with help and in a timely manner. This past year, since their membership grew from 30,000 to 80,000 members, I have had a terrible time getting my needs met or any response,” one disgruntled member wrote.
