New State Regs, Lawsuit Increase Heat on Health Care Sharing Ministries

Scrutiny of health care sharing ministries (HCSMs) is growing, with Colorado becoming the second state to require the entities to submit health care financial data to insurance regulators amid stepped-up scrutiny from state insurance regulators nationwide. Meanwhile, a Florida health system filed a lawsuit challenging the common practice among HCSMs of pushing members to conceal their sharing ministry enrollment when dealing with providers’ billing departments, which Orlando Health contends is an effort to “illegitimately secure the reduced ‘charity rate.’”

HCSM supporters contend that the religious organization-affiliated ministries provide a less expensive alternative to health insurance for members who agree to comply with faith-based lifestyle restrictions and pledge to “share” medical costs among members. But critics say the programs provide no guarantees of coverage and are exempt from much insurance oversight, while still being marketed in many cases by brokers with terminology such as provider networks and benefit design names that mimic traditional insurance.