Steve Rabey, The Gazette

While most Americans secure medical care with health insurance, some go a different route, joining Christian “health share ministries” that connect members to other members who need help paying doctor bills.

Together, the four biggest groups — Medi-Share, Christian Healthcare Ministries, Samaritan Ministries and Liberty HealthShare — claim the majority of an estimated 1 million Americans who rely on health sharing.

Medi-Share is operated by Christian Care Ministries, which is based in Florida but operates a Colorado Springs office of 181 call center workers, care managers, health and wellness coaches, and others in space rented from Focus on the Family.

Medi-Share has more than 403,000 U.S. members who shared $639 million in member medical bills in the 2018-2019 fiscal year. The nonprofit has shared and discounted more than $2.6 billion dollars in medical bills since its founding in 1993. In Colorado, the group has 17,914 active individual and family members, as well as 21 group members who provide health sharing for church staff and ministry employees.

Health share ministries compare their model to crowdfunding and say they’re inspired by depictions of the early Christian communities in the New Testament’s book of Acts: “All the believers were together and had everything in common. They sold property and possessions to give to anyone who had need.”

Medi-Share restricts membership to people who “attest to a personal relationship with the Lord Jesus Christ,” agree to a statement of faith, “attend and actively support a fellowship of believers regularly,” and “live by biblical standards,” which means no tobacco, no abuse of alcohol or medical marijuana, and no sex outside of marriage.

Local health share members say they’re thrilled with monthly bills that are a fraction of the cost of traditional insurance plans, satisfied with the care they receive, and glad to pray for and even send their monthly checks directly to fellow members who suffer.

But health sharing isn’t health insurance, as the four biggest groups acknowledge, and as some unhappy customers have found out too late.

These groups are under no legal obligation to pay anyone anything, they’re not regulated, and they face no external accountability for the important decisions they render.

Colorado’s Division of Insurance has been receiving complaints about health sharing programs since 2016. Last year, the state took unprecedented legal action to halt one group that illegally and deceptively marketed its services and denied member claims.

It’s the kind of thing that keeps Kate Harris awake at night. Harris is the division’s chief deputy commissioner for life and health policy.

“Some of these groups are better actors than others,” said Harris, “but consumers need to be careful about what they’re buying and what kinds of protection they’re going to receive from them.”

Complaints about health share include problems with coverage for preexisting conditions, lifetime limits on coverage and difficulty finding doctors that accept the coverage.

Now, Colorado is among a growing number of states trying to learn more about these groups and protect patients who complain.

Shams and scams

In 2019, complaints about health shares spiked in Colorado and across the country, thanks largely to a new player in the normally quiet industry: Aliera Healthcare, which operates Trinity Healthshare.

According to media reports, the company was launched shortly after one of its founders completed a prison sentence and probation for federal securities fraud and perjury. In 2018, it received $215 million in revenues, but denied many members’ claims, leading the Washington State Insurance Commissioner’s Office to declared the company a “sham” and a “scam artist,” fining it $1 million.

Texas, Massachusetts, New Hampshire, Georgia, Nevada, California, New York and other states are now taking action.

The big four health share organizations, some of which have been around for decades, don’t appreciate the sudden glare of negative publicity.

“Unfortunately, bad actors in any industry cause confusion in the marketplace,” said Wesley Lindsey, Medi-Share’s director of marketing and communications, who declined a phone interview but agreed to answer questions by e-mail.

When asked, Lindsey would not say whether Medi-Share has denied sharing coverage to Colorado members. But the Colorado’s Division of Insurance says it has received complaints about Medi-Share.

Medi-Share was also the source of a complaint to the Colorado Consumer Health Initiative, a Denver nonprofit that works to make health care more accessible and affordable.

“We’ve seen both ends of spectrum,” said CCHI’s Adam Fox.

“We’ve heard from some consumers who like these options because they’ve worked well for them in one way, shape or form. But we’ve also heard from individuals who feel they’ve really been misled by how these arrangements have been marketed to them. They end up needing care, but get stuck holding the bill, because the arrangement denies their claim.”

State considers legislation

New legislation was introduced to the Colorado Legislature in January to deal with health sharing. Colorado House Bill HB20-1008, “Health Care Cost-Sharing Consumer Protections,” 20-1008, would require health share groups to:

• Report information to the commissioner of insurance regarding operations, financial statements, membership, and medical bills submitted, paid, and denied.

• Provide disclosures on their website and in marketing materials.

• Respond to requests for payment of medical expenses from health care providers within a timely period.

• Stop marketing health sharing during the annual open enrollment period for traditional health benefit plans, which has confused some consumers about whether health sharing is insurance.

One of the big four health share groups, Illinois-based Samaritan Ministries International, launched a major public relations and marketing campaign to coincide with the latest open enrollment period.

Medi-Share’s Lindsey said the group was still studying the legislation, but “fully supports the objectives of the legislation to disseminate clear and relevant information regarding the health care sharing ministries operating within each state.”

Medi-Share is a member of the Alliance of Health Care Sharing Ministries, an advocacy group that says health share members “should be free from intrusive and burdensome government control,” and that health share groups “should not be governed or regulated as insurance, but as charities.”

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