The Center on Health Insurance Reforms recently drew attentionto health care sharing ministries' by publishing acommentary on possible concerns about theministry programs.

|

Sabrina Corlette reports in the commentary that she has heard ofsome health care providers running into patients in the ministryprograms.

|

She notes that the programs are exempt from many of the PatientProtection and Affordable Care Act (PPACA) requirements thatnormally apply to new individual and small-group major medicalcoverage, such as the requirement that policies cover childhoodimmunizations and other preventive services, or even a requirementthat the programs submit to any kind of solvency oversight.

|

Read: Ky. rep proposes Christian plan notice rule

|

She also notes anecdotal evidence that providers are seeing morepatients with ministry coverage.

|

Religious groups and community groups have been organizingmember-funded "friendly society" benefits programs since the 1600s.Members were supposed to pay cash into the programs in good timesto get the right to draw cash out in hard times.

|

Insurance companies that build up formal reserves to pay claimsnow dominate the modern U.S. health insurance industry, butreligious organizations began setting up health care sharingministries as an alternative to for-profit insurance companies, orreserve-based nonprofit carriers, in the 1960s.

|

PPACA drafters helped draw attention to the ministries by givingconsumers who join established health care sharing ministries fromthe PPACA provisions that require most individuals to own whatPPACA and the U.S. Department of Health and Human Services (HHS)classify as minimum essential coverage (MEC).

|

Read: Feds map PPACA coverage rule limits

|

HHS and the Internal Revenue Service (IRS) have not yetpublished any readily available statistics on the percentage ofconsumers who have applied or received MEC exemptions based onmembership in a health care sharing ministry.

|

For a look at some of the ministry information that isavailable, read on.

|

|
Increasing numbers bar chart
|

1. The ministry programs may have a significant numberof members.

|

The ministries' advocacy group, the Alliance of Health CareSharing Ministries, says that its two member plans have a total ofabout 286,000 members in about 93,000 households, and that the fiveministries recognized as such for MEC exemption purposes by federalregulators have a total of about 430,000 members.

|

See also: Individual mandate exemption forms out

|

|
Vegetables
|

2. One ministry admits enrollees who agree to anondenominational set of principles.

|

Traditionally, many health care sharing ministries setmembership requirements that were a better fit for members ofProtestant denominations than for Catholics, or for members ofnon-Christian faiths.

|

Some consumers who liked the idea of getting an alternative toPPACA-compliant major medical coverage could not honestly agree tothe best known ministries' membership requirements.

|

Liberty HealthShare, an arm of the Gospel Light Mennonite ChurchMedical Aid Plan, which has been sharing costs since 1995, hasestablished qualification principles that may have more appeal toapplicants who are not Protestant.

|

Applicants may qualify if they do not use tobacco or illegaldrugs; do not abuse alcohol or prescription drugs; are healthy andlead a healthy lifestyle; and agree with the ministry's "sharedbeliefs."

|

The ministry states in its statement ofshared beliefs that, "We believe that our personal rights andliberties originate from God and are bestowed on us by God, and arenot concessions granted to us by governments or men," and that, "Webelieve every individual has a fundamental religious right toworship the God of the Bible in his or her own way."

|

The ministry wants applicants to exercise regularly and "worshipregularly with others," but it does not say how applicants mustworship.

|

See also: 3health industry innovations you really ought to track

|

|
U.S. Capitol, with the dome in scaffolding
|

3. A member of Congress is trying to make ministrymembers eligible for health savings accounts (HSAs).

|

The health care sharing ministries usually have their ownequivalent of a deductible.

|

Liberty HealthShare, for example, sets the "unshared cost" at$500 for a single member and $1,500 for a family.

|

Rep. Mike Kelly, R-Pa., has introduced a bill, H.R. 1752, thatwould change the Internal Revenue Code to let enrollees in anyhealth care sharing ministry treat their coverage ashigh-deductible coverage.

|

Federal tax law normally requires HSA holders to havedeductibles over a minimum level.

|

In theory, if H.R. 1752 passed as written and was implemented aswritten, ministry members might be able to get HSAs even if theyhad unshared cost levels lower the usual minimum HSAdeductible.

|

See also: Highways to PPACA tax penalty freedom

|

|
A balance
|

4. One health care sharing ministry offers a costcalculator that consumers can use to compare the cost of ministrymembership with the cost of PPACA-compliant major medicalcoverage.

|

Members of a health care sharing ministry have to have faith inother ministry members to put cash in, and faith in ministrymanagers to administer the ministry in an orderly way.

|

But, because a ministry is exempt from the usual coveragemandates that apply to health insurance, and from the PPACA ban onuse of personal health information other than age, location andtobacco use in selling and pricing coverage, ministry membershipmay be much cheaper than comparable insurance.

|

The Christ Medicus Foundation has set up a cost calculator thathelps consumers compare the cost of ministry membership and typicalpremiums for PPACA-compliant coverage.

|

For a single 50-year-old, for example, membership in thefoundation's CURO health care sharing ministry might cost onlyabout half as much as the typical unsubsidized cost of gold-levelPPACA exchange coverage, according to the foundation'scalculator.

|

See also: Kingvs. Burwell: What, if anything, should Congress do?

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

Allison Bell

Allison Bell, ThinkAdvisor's insurance editor, previously was LifeHealthPro's health insurance editor. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached at [email protected] or on Twitter at @Think_Allison.