House Democrats approve reporting requirements for health care sharing ministries | legislature

Democrats in the state House approved legislation on Friday to establish reporting requirements for health care sharing ministries, sending the measure to the Senate for consideration.

Health care sharing ministries have surged in popularity in recent years, with supporters describing them as cheaper alternatives to insurance and opponents calling them scams. If enacted, House Bill 1269 would require health care sharing ministries and other non-insurance entities that cover medical costs to submit annual reports to the state, including how much money members pay versus how much in medical bills the entities cover.

“These programs have minimal oversight and there’s no guarantee they will actually pay for anyone’s medical expenses,” said bill sponsor Rep. Susan Lontine, D-Denver. “This is a comprehensive data reporting bill designed to discourage misconduct and promote a necessary level of transparency to protect consumers.”

Health care sharing ministries, also called faith-based health care, are nonprofit organizations that share health care costs among a group of people. The members — who are usually part of the same church or religion — often pay monthly dues to the ministry, and, when one of the members receives a medical bill, the ministry can use the collected money to cover the costs. They are not insured and do not guarantee payment for medical claims.

The ministries say they can reject medical bills for any number of reasons, including moral objections to medical issues resulting from premarital sex, smoking, alcohol use or obesity. They are also not required to cover essential care and can deny coverage based on pre-existing conditions or religious beliefs.

The House passed the proposed bill Friday in a 39-25 vote, with all Republican representatives in opposition and all Democrat representatives in support, except for Colorado Springs Democrat Rep. Marc Snyder, who voted against the bill.

Supporters of the ministries said they’re a less expensive, belief-driven and community-oriented way to address medical expenses, comparing them to credit unions. While opposing the bill, lawmakers also said the Division of Insurance is not the right entity to oversee the ministries, calling the agency hostile to the competition.

“We have to remember what we’re talking about here. These are truly ministries,” said Rep. Patrick Neville, R-Castle Rock. “I can’t think of any time where my church would have to report a private contract they’ve entered into with the Division of Insurance. That’s going to have a chilling effect on these ministries’ efforts to move forward.”

Supporters of the bill say it would help collect information about bad actors using health care sharing ministries to scam people who are unaware that they don’t have to cover their medical bills.

Lontine said she was inspired to pursue the bill after she heard about the lawsuit filed against Trinity Healthshare, where members claiming the health care sharing ministry refused to cover bills from checkups to life-saving surgeries.

Health care sharing ministries have seen a boom in membership thanks, in part, to rising unemployment during the COVID-19 pandemic, resulting in people losing employer-provided insurance. In 2010, fewer than 200,000 people were part of health care sharing ministries. Today, around 1.5 million people are members, according to the Alliance of Health Care Sharing Ministries.

In Colorado, between 50,000 and 60,000 people use health care sharing ministries, the Colorado Consumer Health Initiative estimates. However, the state doesn’t actually know how many health care sharing ministries are in Colorado or how they operate, including how much of their members’ money actually goes towards paying medical expenses.

“These programs may work for some people … more concerning, however, are people who sign up because they see these arrangements as a cheaper alternative to health insurance without recognizing the financial risk they are taking on,” Lontine said. “People need to know why they are priced lower and how they can impact them in the long term.”

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The Colorado Consumer Health Initiative said it has received dozens of complaints from members of health care sharing ministries that refused to pay their medical expenses, ranging from $250,000 in emergency surgeries to cancer treatments to routine doctor’s visits.

Friday’s House vote came after lawmakers debated the bill for nearly four hours the day before. During the debate, Republicans introduced more than a dozen amendments to the bill, including multiple efforts to limit the kind of information the entities would be required to report or what kind of entities would have to report. The amendments failed.

Under the bill, health care sharing ministries would have to report the number of members, how much money is collected from members and how much money is used to cover medical expenses, among other requirements. This information would be made public to inform prospective members and to lay the groundwork for further state action if necessary, Lontine said.

Opponents said this would be an unnecessary burden on the ministries and an infringement on freedom of religion. Rep. Mark Baisley, R-Roxborough Park, described the bill as an overreaching response to the bad actions of a small amount of the ministries.

“It’s unfortunate that that happened in the first place, that people were financially hurt by one bad actor, but the rest are doing some wonderful things for their members,” Baisley said. “We should not allow this bad actor to create the invitation for the Department of Insurance to get involved in this religious ministry of faith where members come together to help each other out.”

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