Christian Medical Plans Get Pass From Health Law Despite Consumer Complaints
Published February 26, 2011 | Associated Press
The brain tumor came back. An ugly mass growing in plain view threatened Karen Niles' remaining eye. She needed more surgery.
This time, however, her medical plan wouldn't pay.
It sounds like one of those insurance "horror stories" that President Obama
hammered home during the fierce debate to pass his health care
overhaul. Except Niles' plan ended up as the beneficiary of a rare
exemption to the new law -- a waiver highlighted in the plan's
promotional materials.
The plan didn't come from an insurer, but from a religious "health
care sharing ministry." Consumer advocates call them a gamble.
These plans successfully lobbied Democratic lawmakers to free their
members from the requirement that everyone in the country have health
insurance.
"Christians are exempt from insurance mandates," Niles' old plan,
Medi-Share, says on its website. Sharing ministries are "the only
organized health care concept to receive a special exemption from the
taxes, penalties and regulations" that the law imposes on insurers, the
site says.
Medi-Share members affirm a statement of Christian beliefs and pledge
to follow a code that includes no tobacco or illegal drugs, no sex
outside of marriage, and no abuse of alcohol or legal medications. Every
month, they pay a fixed "share" to cover the medical expenses of
members in need. The cost usually is less than private insurance, but
it's not tax deductible. Members use a network of medical providers.
If that seems close to regular health insurance, it's not, says
Michael McRaith, the top insurance regulator in Illinois. "We have seen
individuals who buy into a sharing program believing they are paying for
a promise, and in fact that is not what they are receiving," McRaith
said.
"There is no promise or certainty this sharing program will pay for health care expenses," he said.
Florida-based Medi-Share says it's faithfully helped members pay
medical bills for more than 17 years, based on a Bible verse: "Carry
each other's burdens, and in this way you will fulfill the law of
Christ."
"It accomplishes some of the same purposes of health insurance," said
Medi-Share's president, Robert Baldwin. "There are also a lot of
contrasts ... first and foremost, the biblical basis: Members pray for
one another and are prone to encouraging one another."
Karen Niles' husband wouldn't recommend it to anybody. "They have
done their damage on me and my wife," said Robert Niles, a leader and
teacher in his small-town Oklahoma church. Medi-Share's Baldwin blames
state regulators for the Niles' misfortune.
Robert Niles said he found out about Medi-Share from a brochure a
relative picked up on a church retreat. He had changed jobs and needed
insurance. "Everything they said sounded good, so I filled out an
application," said Niles, now 67 and retired from a career in sales.
They joined in 2003. Their monthly shares, or premiums, ranged from $450
to $500.
It's unclear how many people belong to sharing plans, maybe about
100,000. Medi-Share is one of three main ones, with about 40,000
individual members. Members tend to have modest incomes; many are
self-employed.
Each plan has its own rules and track record. Although they have
procedures for dealing with coverage disputes, they're largely
unregulated by state insurance departments that oversee private
carriers.
At first, the plans feared Obama's health care overhaul could put
them out of business. Pressing toward a goal of coverage for all,
Congress was considering a requirement that everyone in the U.S. carry
health insurance. Medical bill sharing is not insurance.
The plans formed the Alliance of Health Care Sharing Ministries,
hired lobbyists and approached the Senate Finance Committee and the
Senate Health, Education, Labor and Pensions Committee, which were
writing much of the legislation. Finance Committee spokeswoman Erin
Shields said lawmakers granted the exemption out of respect for
religious freedom.
"We wanted our members to at least be able to keep participating in
the programs," said Medi-Share's Baldwin. "Down the road, I believe that
it would increase membership, depending on what happens to insurance
costs."
Illinois insurance regulator McRaith says Congress should attach more
safeguards to the exemption, such as requiring sharing programs to have
capital reserves deep enough to handle unusually expensive cases.
If Medi-Share is an insurance alternative, its guidelines carry an eye-catching disclaimer:
"The payment of your medical bills through Medi-Share or otherwise is
not guaranteed in any fashion." Members remain solely responsible for
payment.
Sobering language in these days of runaway costs, but several plan
members said they had no major problems getting coverage to treat costly
life-threatening conditions.
Meredith Crumb of Lafayette, Colo., reckons that Medi-Share paid
hundreds of thousands of dollars to treat her leukemia, now in
remission.
"I found it by word of mouth in the Christian community," said Crumb, 50. "I had top-notch care."
She worries what would have happened to her if she had to rely on
government-regulated coverage. "I know with my medical conditions, if I
lived in Canada or Europe, I'd be dead," she said.
David Dacy of Austin, Texas, said Medi-Share paid tens of thousands
of dollars for his wife's cancer treatment and for surgery to correct
their daughter's deviated septum. He was skeptical when he first heard
about Medi-Share, but signed up partly out of frustration with private
insurance.
Through the years, Dacy said his family had difficulty with the plan
just once, over his daughter's care. But Medi-Share paid. "It wasn't
really a battle, but more effort than I thought was necessary," said
Dacy, 55, an actor and private investor.
Others have had problems. Nevada pastor Michael Rowden sued
Medi-Share over its refusal to pay for treatment of a heart condition.
He eventually reached a settlement. "I was actually embarrassed to be
associated with them," he said.
Before Karen Niles became incapacitated, she was a homemaker and a
church volunteer in Blackwell, Okla. Medi-Share initially paid for
treatment of her brain tumor, but in 2008 told the couple it could no
longer continue to do so. The reason given was that Oklahoma state
regulators had ruled Medi-Share was an insurance company operating
outside the law, and ordered it to stop operations.
"None of us wanted anything to happen to Karen Niles," said
Medi-Share president Baldwin, adding, "if a state tells us we can't
operate in a particular state, we can't operate." Medi-Share had already
paid more than $450,000 for Niles' care.
The Nileses sued, alleging the real problem was that Medi-Share did
not have the money to pay for Karen's treatment. Medi-Share denies the
charge.
The Oklahoma insurance department said Medi-Share could still pay
claims, notwithstanding its order. "There is nothing currently
prohibiting Medi-Share from paying medical expenses at this time, other
than their business decision not to pay them," the department said in a
2009 statement.
The Nileses and Medi-Share agreed to binding arbitration to settle
the suit. Arbitrators ruled last year in favor of Medi-Share, in a 2-1
decision.
"We may agree to disagree on the moral question, but the legal
question was decided in our favor," Baldwin said. Karen Niles was able
to get emergency surgery by joining Oklahoma's high risk health
insurance pool, coverage of last resort for the medically uninsurable.
The premiums, however, were about three times higher than what the
couple paid Medi-Share.
Karen has since turned 65 and joined Medicare, and is under hospice care.
"I'm not saying this wouldn't have happened if she had that surgery,"
said husband Robert. "I couldn't prove that. But I think by waiting so
long, it really did some damage."
There is a great political and cultural shaking currently taking place in the Islamic Middle East that is reminiscent of the rapid fall of the Soviet Union and its European allies in Poland, Germany, and beyond.
In the 1980’s no one (except perhaps President Reagan) would have envisioned the collapse of that vast superpower, which resulted in a united Germany and an openness to the gospel, free-market capitalism and democracy!
Whenever kingdoms fall I am reminded of Daniel 4:25, which says the Most High rules in the kingdoms of men and gives them to whoever He wills.
No one knows how the current revolutions in Egypt, Libya, Yemen, Tunisia and beyond will turn out. But with the advent of Facebook, Twitter, and mobile phones the world is becoming flat. This means the oppressed peoples of the world can afford technologies that keep them “in the loop” as to how people in other nations live and the kinds of religious and political freedoms enjoyed by others. This makes it more difficult for totalitarian regimes (watch out Iran, China, Jordan, North Korea, etc.) to lie to their populations to keep them under control.
This cultural phenomenon can only be altered if central governments figure out a way to control the Internet (something the Democrats in the United States Congress have already begun to speak about). But even then, these governments would have a hard time doing so because of popular demand to keep the Internet unencumbered.
What does all of this mean for the gospel and the spread of Islam?
The current political revolutions can lead to huge open doors for the gospel in the Middle East. The church should be fasting and praying that God’s will be done in regards to the young people in these countries desiring freedom of religion, freedom of expression, and a democratic form of government.
This combination will always favor Christianity over Islam. In the world of ideas, creativity, logic and spiritual power, and if given an even playing field, the church will win back these Arab people groups to the faith of their ancient Christian fathers because of the superior nature of Christianity over Islam and the Bible over the Quran.
We need to pray that radical Islamic groups not come into greater power and enslave the next generation! Islam needs an oppressive political structure to thrive. Historically, Islam has always spread and been maintained by the sword. This is in opposition to true Christianity, which spreads through supernatural conversions by faith in a risen Lord and Savior, Jesus Christ.
Also, I think it interesting that I haven’t heard anyone in the mainstream media talking about how future generations may view the Bush Doctrine in a favorable way, since it was President Bush’s goal to export and establish democratic values in the Middle East when he invaded Iraq. Thus, young people in the Middle East have hope that if a democracy can survive and function in Iraq, there is hope for them if they depose their own despotic rulers.
In regards to the United States: I believe as a nation we rejected Islam in the fall of 2010 when thousands from diverse religious and political backgrounds stood against the building of a mosque near Ground Zero in New York City! Christianity and the democratic values of our Constitution have strong roots in our people. I believe we showed the Islamists they will not get very far with an awakened United States.
Since then, the opposition to building mosques has spread nationally because of the arrogant insensitivity shown by planning to build a mosque near Ground Zero. This has opened a Pandora’s Box for these Islamists as commentator after commentator has exposed their real agenda to impose Sharia law and wage a bloodless jihad via cultural penetration through the building of their so-called community centers. It even seems like pacifist Western Europe is starting to wake up to the dangers of Islam as countries like France are starting to fight against Islamic dominance in their nation. Ultimately all this will be in vain for those who do not turn back to Jesus Christ as the hope of their nations!
In conclusion: We are experiencing a kairos moment in human history. Many Arab nations are at the crossroads. Let us all pray this will result in the spread of democratic political rule resulting in religious freedom, and not the greater imposition of Islamic Sharia law resulting in more slavery and less human rights!