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?