The basic premise of the Affordable Care Act (ACA) is that everybody gets sick at some point, some in ways far more expensive to treat than others. So if everybody chips in a little money steadily over the course of their lifetimes, the burden on none of us will be too great. The key, though, is for everyone to pay in enough to support a certain minimum level of care. Otherwise, we’ll have the same “free rider” problem we’ve had all along: my money paying the bills for people who are not chipping in to pay my own bills when they arise.
Defining that minimum level of care will always be controversial, and reasonable people will disagree over specific details of what should and should not be required. Nearly everyone does agree, though, that if you are going to have such a system at all, everyone needs to be in, or it just won’t work.
Everyone, that is, except shrewd God experts, who have won for themselves an astonishing exemption from the ACA.
ACA exempts three (and only three) so-called “Christian healthcare” outfits (Medi-share, Christian Healthcare Ministries, and Samaritan Ministries) from all of the minimum required expense coverage rules. They are also exempt from the rules requiring coverage for pre-existing conditions. They are even exempt, in many states, from the most fundamental pillar of insurance law: that when a customer has a legitimate claim, the company has to pay it. They do this by cleverly inserting in their promotional materials a little disclaimer saying “This is not insurance.” That’s exactly right—the basic concept of this scheme is to get people to make contributions to a joint fund, and for the managers of the fund to reimburse people’s medical bills only if there is enough money available, if the claimant is still a good Christian, and if they feel like it.
One big mistake a customer can make is to anger God by complaining. There is a very explicit rule that no matter how much you’ve paid in over the years, if you ever take a complaint to a secular court, you are automatically barred from ever receiving another nickel of reimbursement. The Lord may work in mysterious ways, but there’s nothing mysterious about the effect this rule has.
ACA even exempts the financial statements of the golden three from the public scrutiny requirements that apply to real insurance companies. They do have to have an audit, but one that can be performed by a friendly Christian CPA of their own choosing. Moreover, audits aren’t designed to measure how rich the owners and executives are getting, but simply the financial strength of the entity. And when an enterprise has lots of real assets and no real obligations it’s required to pay, how can it be anything other than flush?
Nevertheless, we do know that the granddaddy of them all, Christian Healthcare Ministries (formerly known as Christian Brotherhood), went bankrupt a few years ago. When the court delved into its affairs, the jury ruled that its big shots defrauded the customers of some $15 million spent on luxury houses, motorcycles, expensive cars, and high salaries. One well-paid employee was a stripper, whom they were “trying to help.” (I like helping people, too.) Of course, these problems are completely in the past, and all three companies are now clean as the driven snow. Just ask them, and they’ll tell you so.
So what happens when people who pay money to a “Christian healthcare” scheme—rather than to a real insurance company—don’t get their healthcare expenses covered? No problem! Just let yours truly and all the other suckers who pay taxes foot the bill when they show up, uninsured, at the emergency room.
As the March 31 deadline for individuals to purchase insurance looms, and as the Christian right relentlessly pounds on every stumble in ACA’s rollout, the market for Christian pseudo-insurance has skyrocketed. A recent Fox News report gushes that “Since the launch of HealthCare.gov on October 1, membership at each of the ministries has exploded, with nearly 30,000 new enrollees—more than the number of people who selected a plan through Obamacare in 24 states.” This shouldn’t be surprising for Fox News, whose coverage of Christian healthcare has been so glowing that it makes me wonder whether they have a financial stake in it. A Mike Huckabee segment has the look and feel of a late-night infomercial, with the governor bragging about the very same Christian Healthcare Ministries that went bankrupt a few years ago: “It’s worked for 29 years!”
Why did anyone in Congress vote for this travesty? Why did the president sign it into law? Why isn’t there a huge outcry to make these charlatans follow the same basic common sense rules everyone else has to follow?