Health care sharing ministries in Colorado would be required to report their operations to the state if new regulations passed by Democrat lawmakers on Thursday are signed into law.
Health care sharing ministries have emerged in popularity in recent years, with supporters describing them as cheaper alternatives to insurance and opponents calling them scams. If signed, 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.
“We are not sure how many people are in these plans, we don’t know how many operators there are in the state,” said bill sponsor Sen. Chris Hansen, D-Denver. “That is precisely what we’re trying to solve, to make sure we have a good understanding of the size and scope of these types of operations.”
Senators voted 20-13 in support of the bill on Thursday, with all Democrats voting “yes” and all Republicans voting “no.” Last month, House lawmakers passed the bill in a 39-25 vote almost entirely along party lines. All House Republicans opposed the bill, along with Rep. Marc Snyder, D-Colorado Springs.
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 insurance 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.
Opponents to the bill defended the ministries, describing them as a less expensive, belief-driven and community-oriented way to address medical expenses. Republican lawmakers said the state’s Division of Insurance is not the right entity to oversee the ministries, calling the agency hostile to the competition.
“The insurance commissioner is looking for a way into this thing that’s not insurance,” said Sen. Rob Woodward, R-Loveland. “Not only are they trying to collect the data from them, but they’re also trying to implement fees and costs that will literally put many of them out of business.”
Under the bill, the Division of Insurance would have the power to fine health care sharing ministries or issue cease and desist orders if they do not comply with the new reporting requirements. The fines could go up to $5,000 per day, following a 30-day grace period where the ministry would be informed that it is out of compliance.
Republican lawmakers proposed an amendment to reduce the ends and eliminate the power to cease and desist, as well as more than 20 other amendments seeking to limit the information ministries must report or move them out from under the Division of Insurance. All of the amendments failed.
Sen. Larry Liston, R-Colorado Springs, said he used to be a member of a health care sharing ministry and said the bill is unnecessary because members know what they’re signing up for. However, supporters of the bill said that it is not always the case.
“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,” said bill sponsor Rep. Susan Lontine, D-Denver. “People need to know why they are priced lower and how they can impact them long-term.”
Lontine said she was inspired to pursue the bill after she heard about the lawsuit filed against Trinity Healthshare, where members claimed the health care sharing ministry refused to cover bills from checkups to life-saving surgeries.
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.
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.
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, less 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.