Hannah Metzger, Colorado Politics
Health care sharing ministries in Colorado are now required to report their operations to the state under new regulations signed into law by Gov. Jared Polis on Wednesday.
House Bill 1269 requires health care sharing ministries and other non-insurance entities that cover medical costs to submit annual reports to the state, including how many members they have and how much money members pay versus how much in medical bills the entities cover. The first reports are due Oct. 1, with subsequent annual deadlines falling in March.
Health care sharing ministries have surged in popularity in recent years, with supporters describing them as cheaper alternatives to insurance and opponents calling them scams. Also called faith-based health care, the nonprofit organizations share health care costs among a group of people who are usually part of the same church or religion. Members often pay monthly dues to the ministry and, when one of the members receives a medical bill, the ministry can use the collected money to cover the costs. They are not insurance and do not guarantee payment for medical claims.
“Currently, very little information is known about these arrangements,” said bill sponsor Rep. Susan Lontine, D-Denver, adding that many people don’t recognize the “financial risk” of joining such entities. “People need to know why they are priced lower and how they may impact them long-term.”
The ministries say they can reject medical bills for any number of reasons, including moral objections to medical issues resulting from premarital sex, smoking, alcohol use or obesity. They are also not required to cover essential care and can deny coverage based on preexisting conditions or religious beliefs.
Supporters of the bill said the state must take action to monitor health care sharing ministries, pointing to a lawsuit filed against Trinity Healthshare where members claimed the ministry refused to cover bills from checkups to life-saving surgeries. The Colorado Consumer Health Initiative said it has received dozens of complaints from members of health care sharing ministries that refused to pay their medical expenses, ranging from $250,000 in emergency surgeries to cancer treatments to routine doctor’s visits.
Opponents defended the ministries, describing them as a less expensive, belief-driven and community-oriented way to address medical expenses. Critics to the bill said the state’s Division of Insurance is not the right entity to oversee the ministries, calling the agency hostile to the competition.
The bill passed the legislature nearly entirely along party lines, with Democrats in support and Republicans in opposition. Rep. Marc Snyder, D-Colorado Springs, was the only lawmaker who voted outside of his party, opposing the bill.
“The insurance commissioner is looking for a way into this thing that’s not insurance,” said Sen. Rob Woodward, R-Loveland, while voting against the bill. “Not only are they trying to collect the data from them, but they’re also trying to implement fees and costs that will literally put many of them out of business.”
Under the bill, the Division of Insurance will have the power to fine health care sharing ministries or issue cease and desist orders if they do not comply with the new reporting requirements. The fines could go up to $5,000 per day, following a 30-day grace period where the ministry would be informed that it is out of compliance.
In Colorado, between 50,000 and 60,000 people use health care sharing ministries, the Colorado Consumer Health Initiative estimates. However, the state doesn’t actually know how many health care sharing ministries are in Colorado or how they operate, including how much of their members’ money actually goes toward paying medical expenses.
Health care sharing ministries have seen a boom in membership thanks, in part, to rising unemployment during the COVID-19 pandemic, resulting in people losing employer-provided insurance. In 2010, less than 200,000 people were part of health care sharing ministries. Today, around 1.5 million people are members, according to the Alliance of Health Care Sharing Ministries.