N.Y. Accuses Religious Health Cost-Sharing Group of Misleading Consumers

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The ministry plans may seem even more attractive under a new rule proposed by the Trump administration that would give tax advantages to people buying coverage in a health care sharing ministry, said JoAnn Volk, a research professor at Georgetown University.

If the rule is finalized, people may become even more confused about whether this coverage amounts to real insurance, she said. “This could potentially exacerbate the problems we had before,” she said.

Matt Lesser, a state senator in Connecticut, said in a warning issued earlier this month by the insurance department: “I’ve personally heard from constituents who have paid for products they believed were health insurance. These reports are alarming — and consumers should be on the lookout. Many of these products claim to be ‘Health Care Sharing Ministries’ which are not insurance and may not cover needed medical care.”

Trinity and Aliera face lawsuits from consumers in four states who say they have been misled. Jay Angoff, a former federal health official and state insurance regulator who is one of the lawyers representing them, says the complaints are widespread. “We’re getting unsolicited calls from people who are saying Aliera hasn’t paid their claims in other states,” he said.

By one estimate, more than 1.5 million Americans have joined Christian groups in which they agree to share medical expenses with other members. People are attracted by prices that are far lower than the cost of traditional insurance that carries strict requirements set by the Affordable Care Act, like guaranteed coverage for pre-existing conditions.

The Christian groups can offer low rates because they are not classified as insurance, and are under no legal obligation to pay medical claims. Some people have paid hundreds of dollars a month, and then have been left with hundreds of thousands in unpaid medical bills in several states where the ministries, which are not subject to regulation as insurers, failed to follow through on pooling members’ expenses.

Aliera, which is based in Georgia, was the subject of an investigation by The Houston Chronicle. The Texas attorney general sued Aliera to stop it from offering “unregulated insurance products to the public.”

An administrative hearing for the New York case is scheduled for February.



Source : Nytimes