Ministries offer bill-sharing as insurance alternative

The programs have come under scrutiny by regulators, courts and legislators.

By Emily Berry, AMNews staff. July 7, 2008.

The staying power of Christian medical bill-sharing plans has judges, legislators and regulators asking a philosophical question: Does a plan count as insurance if it doesn't charge premiums or pay claims, yet allows people to contribute to a pool of money they can draw upon to pay medical bills?

The answer to that question might depend upon a reading of state insurance law, whether a state has passed exemptions for religious organizations that pay for medical bills, or even the religious sensibilities of the parties involved.

Backers of these plans say they provide a low-cost alternative to insurance for people who otherwise couldn't get it or afford it. Their detractors say these plans are insurers in sheep's clothing, trying to find a way to shimmy out of state insurance financial and coverage regulations.

Either way, doctors might not know their patients might be participating in these bill-sharing plans, because often the plans are constructed so a physician is paid in cash first, after which the patient's bill is published in a plan's newsletter, with a request for reimbursement. However, sometimes physicians face the same wait for payment as they do for any health plan.

Christian bill-sharing plans aren't new, but have attracted more attention lately because of regulatory and legislative activity, and because the plans are being pitched as an alternative to not being insured -- though they say they're not insurance.

The Cover Florida health reform plan Gov. Charlie Crist signed in May included an amendment exempting faith-based health care programs from state insurance regulation, as long as the group qualifies under federal guidelines as a nonprofit religious organization.