{"id":74693,"date":"2020-02-04T15:03:39","date_gmt":"2020-02-04T22:03:39","guid":{"rendered":"https:\/\/dh.durangoherald.com\/tj\/colorado-lawmakers-want-to-crack-down-on-health-care-ministries\/"},"modified":"2020-02-04T22:03:39","modified_gmt":"2020-02-04T22:03:39","slug":"colorado-lawmakers-want-to-crack-down-on-health-care-ministries","status":"publish","type":"post","link":"https:\/\/dh.durangoherald.com\/tj\/colorado-lawmakers-want-to-crack-down-on-health-care-ministries\/","title":{"rendered":"Colorado lawmakers want to crack down on health care ministries"},"content":{"rendered":"\n

\"Rep.
Rep. Susan Lontine, D-Denver, in the Colorado House on April 30.<\/span>Jesse Paul\/The Colorado Sun<\/span><\/figcaption><\/figure>\n<\/p>

Recently, a Colorado woman was badly beaten in an act of domestic violence, her medical bills totaling in the tens of thousands of dollars. But when she asked her health coverage provider to help with the costs, she said the company denied her claim on the grounds that she had engaged in immoral behavior.<\/p>\n

She had been drinking before being attacked.<\/p>\n

That experience, recounted to state regulators, was one of about a dozen complaints <\/a>that led the Colorado Division of Insurance last year to shut down a so-called health care sharing ministry<\/a> operating in the state. Last month, Colorado\u2019s insurance commissioner made the order final as part of a settlement, preventing the ministry, Trinity HealthShare, and the company that administers it, Aliera Healthcare, from marketing sharing ministries in the state for the foreseeable future.<\/p>\n

Sharing ministries \u2014 many of which are religiously based \u2014 look a bit like regular health insurance, pooling members\u2019 money to help pay for everyone\u2019s medical care. In a world of high health insurance premium prices and deductibles, the ministries\u2019 lower costs can be enticing to consumers.<\/p>\n

But the plans are exempt from federal insurance requirements and, as a result, provide fewer \u2014 if any \u2014 guarantees. They can have lifetime or annual caps on benefits, can charge people more based on their health and can deny coverage for any number of reasons \u2014 including based on religious belief. Ultimately, and unlike traditional insurance, they have no obligation to pay a member\u2019s claim.<\/p>\n

To consumer advocates and, increasingly, state officials across the country, that makes sharing ministries ripe for abuse<\/a>. In investigating Trinity and Aliera, Colorado authorities also heard about needed surgeries and cancer treatments that wouldn\u2019t be covered.<\/p>\n

\u201cThey were really devastating,\u201d Kate Harris, the state\u2019s chief deputy insurance commissioner, said of the complaints her office received. \u201cThe commonality of all of these was people who thought they had financial protection from this company that they did not have.\u201d<\/p>\n

Now, state lawmakers are looking to create more rules for the ministries.<\/p>\n

House Bill 1008, which is scheduled for its first committee hearing Tuesday, would require sharing ministries to be more upfront with consumers about how they operate and would explicitly prohibit misleading advertising about the plans. The bill would also give regulators more oversight of sharing ministries.<\/p>\n

State Rep. Susan Lontine, a Democrat from Denver who is sponsoring the bill, said she has heard complaints not only from consumers but also from doctors who are frustrated that they have to hound their patients for money when the sharing ministry won\u2019t pay up.<\/p>\n

\u201cSo there\u2019s harm to the doctor-patient relationship when that happens,\u201d she said.<\/p>\n

But she\u2019s also heard from plenty of consumers who say the sharing ministries work well for them. Lontine said she hopes, with some tweaks to the bill, that she might even get a number of sharing ministries to support her legislation.<\/p>\n

\u201cWe don\u2019t outlaw them,\u201d Lontine said. \u201cIf they behave and do what they say, they\u2019re still allowed to do business.\u201d<\/p>\n

Because sharing ministries don\u2019t currently have to report any numbers to the state, it\u2019s unclear how many are operating in Colorado and how many people are enrolled in them. The Alliance of Health Care Sharing Ministries has said Colorado is one of the top 10 states for enrollment in the programs, with around 53,000 people enrolled as members.<\/p>\n

Trinity had about 3,200 members in Colorado. The Division of Insurance has created a special open-enrollment window for those members so they can transition to regulated insurance plans.<\/p>\n

Health care sharing ministries have increasingly been in state officials\u2019 crosshairs across the country, with Trinity and Aliera also the subject of regulatory action in at least three other states.<\/p>\n

\"The
The Colorado Division of Insurance sent cease and desist letters to Aliera Healthcare and Trinity Healthshare in August 2019, accusing them of selling insurance without a license.<\/span>John Ingold\/The Colorado Sun<\/span><\/figcaption><\/figure>\n<\/p>

Harris said the problem isn\u2019t with the model \u2014 sharing ministries have been around in small religious communities for decades. It\u2019s with sharing ministries that don\u2019t make it clear to potential members that they are not the same as insurance.<\/p>\n

\u201cThey were acting basically like insurance companies,\u201d Harris said. \u201cThey used slightly different language in some cases. But, at the end of the day, they\u2019re making assurances of payment for services. And what we were hearing from consumers was, by and large, that their claims were not being paid.\u201d<\/p>\n

Harris said the state has evidence that Trinity and Aliera were spending no more than 20% of what they took in in premium dollars on their members\u2019 medical bills \u2014 \u201cshockingly low,\u201d Harris said. By contrast, traditional insurance companies have to pay out 80% to 85% of the premium dollars they take in.<\/p>\n

Neither Trinity nor Aliera admit any wrongdoing as part of their settlement agreements with the state. In a statement on its website, Aliera said it intends to continue with other types of health care businesses it operates in the state. The company also runs an insurance brokerage, an information technology company and others.<\/p>\n

\u201cWhile we fully cooperated with the division\u2019s inquiry, it\u2019s disappointing that in Colorado we are unable to provide future (health care sharing ministry) services on behalf of ministries,\u201d Chase Moses, Aliera\u2019s president, said in the statement.<\/p>\n

Trinity said it had been ready to fight the state\u2019s shut-down order prior to the state\u2019s offer of settlement negotiations, and it vowed to continue on in other states.<\/p>\n

\u201cThe vast majority of Trinity\u2019s members, both in Colorado and around the country, are very satisfied with our health care sharing ministry and continue to choose us because it\u2019s a cost-effective medical payment arrangement,\u201d Joe Guarino, Trinity\u2019s president, said in a statement on the organization\u2019s website.<\/p>\n

Adam Fox, the director of strategic engagement at the pro-consumer Colorado Consumer Health Initiative, said complaints his organization has received about health care sharing ministries have dropped off since the Division of Insurance shut down Trinity and Aliera.<\/p>\n

But Harris said her office is currently in the early stages of investigating other sharing ministries in the state. That process could take months, but she declined to say more.<\/p>\n

\u201cI can\u2019t get into too much detail at this point,\u201d she said.<\/p>\n

The Colorado Sun is a reader-supported, journalist-owned news outlet exploring issues of statewide interest. Sign up for a newsletter and read more at coloradosun.com.<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

after a ministry with \u2018shockingly low\u2019 payouts and was shut down<\/p>\n","protected":false},"author":1,"featured_media":74694,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[394,21,28],"naviga_topic":[],"class_list":["post-74693","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","tag-colorado-legislature","tag-cortez","tag-headlines"],"acf":[],"author_name":"dh_admin","_links":{"self":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts\/74693","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/comments?post=74693"}],"version-history":[{"count":0,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/posts\/74693\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/media\/74694"}],"wp:attachment":[{"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/media?parent=74693"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/categories?post=74693"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/tags?post=74693"},{"taxonomy":"naviga_topic","embeddable":true,"href":"https:\/\/dh.durangoherald.com\/tj\/wp-json\/wp\/v2\/naviga_topic?post=74693"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}