Today we look at the somehow-legal world of healthcare sharing ministries, a form of health coverage where like-minded religious folks share health care costs. After a series of lawsuits and scandals, these companies are in the news again recently. We’ll look at what HCSMs are, how they have flourished as insurance costs rise, and the potential risks they pose to the unsuspecting consumer. Then we’ll turn the page to talk about how communities of faith are playing a key role in winning a just and equitable healthcare system.

Today we look at the somehow-legal world of healthcare sharing ministries, a form of health coverage where like-minded religious folks share health care costs. After a series of lawsuits and scandals, these companies are in the news again recently. We’ll look at what HCSMs are, how they have flourished as insurance costs rise, and the potential risks they pose to the unsuspecting consumer. Then we’ll turn the page to talk about how communities of faith are playing a key role in winning a just and equitable healthcare system.

Our guest today is the Reverend Jim Rigby. Rev. Rigby has been the pastor at St. Andrew’s Presbyterian Church in Austin Texas for over 25 years. He has a love of world religions and a passion for social justice. Healthcare justice has been a part of his ministry because he believes that healthcare is the most basic right to life, along with a living wage and decent housing.

https://www.youtube.com/watch?v=GeRIN9nF-to

Show Notes

What are Health Care Sharing Ministries?

Ben explains that healthcare sharing ministries (HCSMs) are a form of health coverage in which members, who share religious beliefs, make monthly payments to cover the healthcare costs of other members.

BUT they are not insurance. Insurance is supposed to cover most of your healthcare services, with cost-sharing by the patient. HCSM are much cheaper than insurance, which is why they're so alluring. But they cover much less, and only pay for a fixed amount of a service, regardless of the total cost. HCSMs, unlike insurance companies, don't take on any risk.

The ministries are typically Christian. Members generally must declare their religious faith and promise not to smoke, drink alcohol excessively, or engage in extramarital sexual activity. Generally, they also do not cover abortion, mental health services, or birth control. Unlike insurance, HCSMs can deny coverage for people with pre-existing conditions.

The ACA used to fine people for not having insurnace, but HCSMs were exempted from that fine even though they do not meet the federal definition of insurance. (That fine was eliminated under the Trump administration, and the Biden administration hasn't reinstated it.)

HCSMs have been around since the 80s, but grew in popularity during the 90s and again after the passage of Obamacare – basically whenever we see concerted efforts to make the government responsible for more healthcare costs.

“About 1.5 million Americans are members of these kinds of ministries, according to the Alliance of Health Care Sharing. Some $2 billion in medical expenses were shared through this type of ministry in 2020.  There are over 100 health sharing organizations certified by the U.S. Department of Health and Human Services for meeting the federal law’s definition of a health sharing ministry.” – Reported in Catholic World Report in May 2022.

Unregulated HCSMs leave people behind and contradict the religious values they claim to be based on

Health insurance companies aren't well-regulated in the United States, but they still have to operate under some basic regulations. Gillian explains that there are virtually no regulations on HCSMs. As a result their practices can be exploitative.

Thirty states actually have “safe harbor” rules that exempt HCSMs from the restrictions on insurance companies. In “safe harbor” states, as long as members receive a written disclaimer from the HCSM...