Medi-Share, the ACA and the religious exemption flimflam

While you weren't noticing, many Americans have been opting out of the Affordable Care Act under the law's religious exemption provisions primarily through a Florida outfit called Medi-Share.

Let's be clear - Medi-Share is not insurance. It's a cost sharing plan where individuals apply for membership and agree to pay for each other's medical expenses through a shared pool of "donations". It doesn't cover routine checkups and many other common expenses and offers no guaranteed coverage if the members are hospitalized.

In October of last year, a Kentucky judge shut down the operation in Kentucky after objections by insurance companies who maintained that the plan was being offered as "insurance" and misleading members. The service is still legal in NC.

Indeed, Medi-Share tries to have it both ways in their Guidelines - on the one hand saying "Medi-Share is not insurance" and, on the other, saying it "can be used as an exemption from mandated insurance coverage". But notice this fine print:

Each Medi-Share member is solely responsible for the payment of his or her own medical bills at all times. Neither CCM nor other Members guarantee or shall be liable for the payment of a Member’s medical bill. Further, no Member may or shall be compelled to make sharing contributions. If sharing occurs, the shared medical bills are paid by the Member that incurred the bill solely from voluntary contributions of Members, not from funds of CCM itself.

To be eligible, members have to provide a Statement of Faith, attend church regularly, cannot use tobacco or illegal drugs, and "must not engage in sex outside of traditional Christian marriage". The plan does not cover:

The following events/conditions are not eligible for sharing: elective cosmetic surgery, mental illness and depression, pregnancy, chronic fatigue syndrome, fibromyalgia, Epstein Bar Syndrome, causes from acts of war. The following events/conditions will not be eligible for sharing unless surgery is involved: carpal tunnel syndrome, back injuries, and knee injuries. (For instance: a member has been diagnosed with carpal tunnel and doctor states surgery is required. The event/condition will then be eligible.)

Their plans also don't cover "non-Biblical" healthcare, including abortion or "morning after" pills. There are also other restrictions placed on care caused by motor vehicle accidents.

Medi-Share seems to offer less than the "junk" insurance policies that were prohibited under the Affordable Care Act.

My prediction - after a couple of years under the ACA, you'll start seeing news exposes about Medi-Share members that bought into the plan to avoid getting "Obamacare" and wind up in bankruptcy after a catastrophic illness.

Remember - the people in this plan that can't pay their bills - care that would be covered under ACA mandated plans - will be driving up the costs of healthcare for the rest of us, defeating the whole purpose of healthcare reform.

I'd like to see a reporter work with some insurance and ACA professionals to do a full analysis of Medi-Share and how it compares to more traditional ACA or employer provided healthcare options.

Conservative news sites and outlets, like NewsMax and FoxNews, have been hawking Medi-Share as an "opt-out" option for individuals that can't stand the idea of "Obamacare" and Medi-Share itself seems to promoting itself that way through their own website.

Is it a viable option or just a bait and switch?

Comments

Medi-Share

Inaccuracies in your article. Medi-Share does not pool money. That is illegal for a faith based sharing ministry to do. Medi-Share has existed for 21 years. So why would there be problems two years from now if it has been working for 21 years. The disclaimer that you object to (Not Insurance and No Guarantee) is forced upon them by insurance commissioners in the different states. They must say that or they can't operate in most of the states. It is not their idea it is the state insurance commissioners MANDATE. What part of the individual members freedom of choice and freedom of religion do you object to?

I was a member of Medi-Share until I turned 65 some years ago and the government put me on Medicare. As a member of Medi-Share the members paid over $200,000 in medical bills for me due to a heart attack in 2001. They paid them on time and I have NO COMPLAINTS! No one is forcing you or the members of Medi-Share to join they are free to choose unlike the ACA. Medi-Share is legal in Kentucky. A simple search of the internet will show that. As far as not paying for the morning after pill. The pro-abortion position used to be freedom of choice but now Christians are barred from the choice of not paying for abortions for others. Federal law forbids forcing taxpayers money to pay for abortion yet the ACA forces them to fund it. So much for freedom of choice.

Now let's address not paying for certain procedures. None of those procedures would bankrupt anyone but the poorest person. The poorest people can join the ACA and be subsidized. None of the unshared conditions are life threating conditions. No one is forcing anyone to join Medi-Share. I doubt many of the things like cosmetic surgery are paid for by ACA plans. The motor vehicle accidents restriction simply says that your motor vehicle insurance which every state forces you to have must pay first before Medi-Share. Auto insurance usually says that if you have health insurance they are secondary to it. So the state forces you to buy auto insurance which says it is secondary. That literally means it isn't going to pay much if anything. Nice deal for the auto insurance company. Of course we are talking about injuries not you auto. Not sure what you mean about "Remember the people in this plan that can't pay their bills." If they could pay their bills they wouldn't need to join "the plan." Oh! I almost forgot it isn't a plan, yet another error calling it a plan. It is a ministry not insurance. I support FREEDOM and Liberty for all. Not Mandates for all. We have a big difference. I will not force my beliefs on you. Please do not force your beliefs on me.

Thanks for the info

Regarding not forcing one's beliefs on others, how do you feel about NC's Amendment One and the recent anti-abortion laws passed by the NCGA?

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Do you reall want a law that stops charity?

Do you really want a law that stops a charity from helping people get their medical bills paid? Would you rather the government or tax dollars paid their medical bills? Do you want to put an end to me helping my friends pay their medical bills? Can you even pass a laws that says I can't help you pay your bills? WOW! What kind of compassion is that?

That's all well and good

but it (intentionally?) avoids my question: Regarding not forcing one's beliefs on others, how do you feel about NC's Amendment One and the recent anti-abortion laws passed by the NCGA?

You broached the topic. You owe us an answer.

Do you have one?

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

No constraints

Are you saying that if you win an election you have the right to do anything that you want to the looser? If so you better hope that you never lose an election. Do you believe that the looser must be in submission to a dominating influence? I was simply correcting the facts about Medi-Share not commenting on or whining about your agenda. If you call my statement about being pro freedom whining about your agenda then I guess I was whining.

Just to clarify,

the "whining about agenda" thing that has you riled is not part of his comment, it's a signature feature that shows up at the bottom of all his comments. It has nothing to do with you or what you said. In fact, it's a quote from a Republican, actually.

and, um, yeah...

the signature is a quote from Thom Tillis. One of the nation's most vociferous foes of Obamacare, in an effort to get himself elected to the US Senate (God forbid).

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Well

it sure seems that Thom Tillis and Phil Berger think that because they "won" an election (via the nation's worst gerrymandering), that they have the right to do anything they want.

They stomped on the poor, middle class, women and minorities; they took away the constitutional right to vote for hundreds of thousands of people and they passed laws that courts have deemed unconstitutional.

So are you making an argument about principles or are you making a partisan argument? Is it OK if the GOP does it but not the Dems? Or vice versa?

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Medi-Share redux

You're a new member of BlueNC and I have no way of knowing if your story about Medi-Share is true or if you might be a "shill" posting on behalf of Medi-Share or one of the anti-ACA political groups trying to steer individuals away from signing up with the healthcare exchanges.

If you're genuine and Medi-Share worked for you, more power to you.

Indeed, I shouldn't have used the word "pool". It's rather difficult to describe Medi-Share's model, but they use the words "member donations" in their legal materials at the site.

Granted, Medi-Share has been around for 21 years, but that doesn't mean the model wouldn't have problems. Goldline, the gold and silver retailer pitched by Glen Beck, was founded in 1960, but it's been the subject of considerable controversy and lawsuits over the past decade over practices that have been misleading to consumers.

My main concerns are that Medi-Share, with its website describing plans, coverage and participating healthcare providers looks just like insurance on the surface, but isn't.

Insurance companies are highly regulated to protect consumers. State and Federal authorities issues licenses for operating in states and territories and insurance companies have to prove that they're solvent and can cover possible claims. Their product offerings are regulated and standardized to both ensure that companies can remain solvent and to provide consumers with ways to compare insurance providers.

In effect, Medi-Share is acting like an insurance company outside of the state and federal regulations that would protect consumers. It calls itself a "ministry", but everything about what it offers looks like an insurance company.

Medi-Share has been operating "under the radar" for several years, but with the coverage it's getting in conservative media, it may be attracting individuals that think they're getting something that would be similar or equivalent to coverage from a traditional insurance company, either privately, through an employer or the healthcare exchanges. From what I can tell, it isn't.

My interest here is in getting a reporter with a more neutral media outlet to look into Medi-Share more extensively to really explain how it works and what the differences are between traditional insurance and Medi-Share. The benefits and potential risks need to be more clear to consumers.

Good post

I am for real. I do not work for or speak for Medi-Share. I was a member. I knew what it was when I joined. I think that their information is quite clear if you read it all. The fact that the insurance commissioners require a specifically worded disclaimer says there is some form of regulation. I would agree that it is minuscule but it is worded to tell the joiner that this is not insurance and not guaranteed. Do people still get confused and join thinking it is insurance. I would bet money on it. People run traffic lights but I wouldn't do away with them for that reason. There are other groups out there that are Denomination specific. The Amish take care of each other. The Catholics have a sharing group that is not well known. The Mennonites take care of their own. I understand that the Lutheran's have a group. The concept is as old as the Bible it's self. Insurance companies go belly up. People get hurt, it is unfortunate. In the top 10 causes of death are medications taken as directed. You hear the disclaimers on medicine TV ad's. People still take them and die that is why it is in the top 10 killers. Freedom to chose is not without it's risks. No freedom to chose is also
fraught with dangers.

I would disagree that everything Medi-Share offers looks like an insurance company. At some level it looks like an insurance company because it pays medical bills. To those who do not or will not read their information it could be perceived like insurance. There are several model for paying medical bills other than insurance. Concierge medical services are what many providers are going to. There are medical Savings Accounts which are not insurance but are connected to catastrophic coverage. Many fortune five hundred companies self insure. There is "self pay". They are regulated but not to the extent that an insurance company is.

Got to run!

Enjoyed the exchange with you!

Got to run!

"Liberty Sponsor" (a misleading moniker) came barging in to BlueNC on his or her bungee cord, fired his or her flamethrower and then, as the bungee cord retracted, wrote "Got to run!".

Without responding to a whole lot of legitimate questions or engaging in some legitimate debate.

Give me liberty, or give me...er...uh...trolls?

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Just for the record

I checked BlueNC's admin panel. "Liberty Sponsor" created his/her account just before they posted a response to my post about Medi-Share.

Their IP address is located in Vero Beach, Florida. According to Google Maps, that's about 40 mins away from Melbourne, Florida, the location of Medi-Share's headquarters.

WOW are you looking for a

WOW are you looking for a fight? Look for someone else. I just barged in (not sure how I did that) to clarify some misconceptions about Medi-Share. I fought for you right to free speech so have at it. Just don't care to listen to it. You are one angry dude. I didn't answer your question about the NCGA bill because I haven't read it. Don't want to comment about something I haven't read. Lot of that going around. "We need to pass it to find out what is in it" kind of stuff. I did ask a couple of on subject type of questions about freedom to help my friends pay their bills and you didn't answer them. So why are you mad at me. Aren't there rules about changing subjects? I see Medi-Share differently than you do. You see it as a threat or a scam or something bad. I see it as a "community organizer" They organized a community of Christians into helping each other pay their medical bills. It has worked for 21 years. Don't tell me you are against "community organizers." They don't even handle the money.

Yes I am in Vero Beach right now. I wonder how far do I need to be from Medi-Share before I can speak. I am closer to a garage than to Medi-Share. No one has suggested that I am a car. Not sure what a misleading moniker is but a bet it's not complementary. Really did have to go. Really am going to bed. Won't be back to this blog, so I guess I am barging out. Have a nice day. :)

Remember you reap what you sow.

Thank you for barging out

We get hit-and-run visitors all the time, and it rarely ends well, especially when they are of the libertarian persuasion. There is something sanctimonious about having glib answers ... the magic, invisible hand and "freedom!" ... to all of the complex challenges we're facing.

And to be clear, you have no special status for having fought for free speech. Thank you for your service, but many of us, including me, are veterans with many years in the military.

Thank you for barging out.

Should you happen to barge back in...

...and don't feel you have to be in a hurry...

Maybe you can enlighten us further about your objections to forcing one's beliefs on others.

Namely, how do you feel about NC's Amendment One and the recent anti-abortion laws passed by the NCGA?

Bungee!

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Sorry that I don’t understand

Sorry that I don’t understand the etiquette of blogging. Not sure what barging in or out is and how one refrains from that while commenting. Or is that just some type of insult. Not sure what a bungee is either. If that means one must now and forever keep up this thread then I guess I am a bungee.

Since you insist I will try to answer your questions but then I am out OK? Once again I haven’t read the bill so I can’t comment. But if you are trying to pin me on my position on abortion then it comes down to truth. Question when is a baby a human being? A mother can not kill her baby after it is born that’s murder. She can kill it 5 minutes before it is born that’s the right to control her own body. I can’t figure out why that is. As someone pointed out I am currently in Florida. It is illegal to mess with turtle eggs (unborn turtles) laid on the beach. You get arrested for doing that. So why are unborn turtles protected and not unborn humans? This argument has gone on since abortion was legalized (oops) the supreme court deicide that they would legalize it not the congress.

Concerning the argument that it is a woman’s body. You do not have the right to do anything to your own body you want to do. An example of that would be taking illegal drugs. I don’t think that it should be legal, so no I am not a Libertarian. Before you go there I am not a Republican or Democrat either. It seems that most people want to put you in box so they can criticize the box that they put you in. That is why you are trying to determine my position on abortion when the subject was inaccuracies about Medi-Share.

A woman is forced against her will to take out insurance to cover her own body. Does she own and control of her own body if she is forced to take the insurance? If she has to work to pay for the insurance she is not in control of her body while she is being forced to work to buy the insurance. If she is given the insurance free or it is subsidized then someone else (the provider) is in control of her body, dictating what doctors, and procedure she may have. She is therefore not in control. If she has the freedom to choose insurance plans or Medi-Share with or without certain benefits then she has control based on the choices available. The more choices she has the more control she has. One choice is to choose to take nothing. That freedom of choice has been taken away from her. Slavery is one person being forced to work to provide benefits to another. Freedom is one person choosing to work even if it provides benefit to another.

All law is someone forcing their morality on someone else.

Got it

You are perfectly FINE with people forcing their views on others through force of law as long as it's your views that are being forced.

Hypocrite much?

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

And we think

We have a pretty good line on your views about forcing gay marriage views on the rest of society.

Over and out.

Have a nice day!

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Liberty, In regards to

Liberty,
In regards to protecting turtle eggs, I'd like to point out that turtles are protected by law as some are approaching the verge of extinction. Humans are not.

Not only that

but most turtles are more pleasant than many humans.

Although there are exceptions

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"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014