HSTA Protects Consumers Against Unregulated Religious “Healthcare Plans”
Photo by Greg Rosenke on Unsplash Healthcare sharing ministries (HCSMs) are highly unregulated, cost-sharing organizations that masquerade as health insurance. Commonly associated with evangelical Christian beliefs, these risk-pooling groups are open to people who share religious or ethical beliefs. HCSMs have wide discretion to deny claims based on the moral or religious beliefs of their organizers. They often falsely advertise as health insurance, although their plans are not true insurance. Instead, they are unregulated cost-sharing organizations that often leave enrollees with devastating and unexpected medical bills. HCSMs are not required to comply with many consumer protections, they are not required to cover health expenses, and they prey on individuals who believe they have purchased health insurance.
For example, an HCSM can deny claims for LGTBQ+ individuals, for reproductive healthcare, for not complying with religious strictures, and more. Some of the largest plans exclude treatment for things such as mental health, substance abuse, autism, and obesity. Additionally, HCSM plans are advertised in a way that makes them appear to be real health insurance and are even sold by brokers. This can deceive enrollees into thinking they’ve purchased health insurance, only to have the truth become devastatingly evident when enrollees receive giant medical bills for denied claims.
HCSMs are so problematic that Last Week with John Oliver devoted a major segment to exposing them last year.
The Health Share Transparency Act, sponsored by Rep. Jared Huffman (CA-2), would put a stop to the deceptive practices of HCSMs by holding them accountable and requiring disclosures to current and prospective enrollees.
Huffman is the co-founder and co-chair of the Congressional Freethought Caucus, which promotes public policy based on reason, science, and moral values, and protects the secular character of the US government. Rep. Jamie Raskin (MD-8), the other co-chair of the Caucus, is a co-sponsor.
The new legislation would require HCSMs to prominently disclose to potential and current enrollees that, unlike health insurance coverage or group plans, enrollees are not guaranteed claim reimbursements. HCRMs would also be required to provide the total amount the HCRMs paid for available benefits compared to the total amount enrollees were required to cost share. Other important disclosures would include enrollment levels, the number of denied claims, the average length of time it takes to reimburse claims once submitted, and details on consumer complaints.
Describing HCSMs and how his bill would protect consumers from them, Huffman said,
Health Care Sharing Ministries prey on citizens in search of care, using overt appeals to religion as a veil to avoid criticism and regulation. They mislead the public into falling victim to this dangerous scheme through marketing materials that closely emulate traditional insurance despite their persistent failure to provide even the most basic health care services. It is completely unconscionable that an entity would trick consumers into purchasing inadequate health coverage, leaving folks to hold the bag and risk bankruptcy when they need help the most. The threat posed by these unregulated, deceptive HCSMs demands federal action. And that starts with having accurate information at hand to ensure consumers make the best choices for themselves and their loved ones.
The bill also requires health insurance brokers to explain to potential enrollees that HCSMs are not health insurance coverage or group health plans, that benefits under HCSMs are not guaranteed, and that potential enrollees who are qualified may be eligible to enroll in health coverage like Medicare and Medicaid.