When David Martinez of Dallas switched jobs and needed to look for affordable health insurance, a broker steered him to a purported health care sharing ministry. According to the Houston Chronicle, “[i]t sure sounded like insurance to Martinez. Or close enough.” He paid in thousands of dollars, but when his wife underwent a surgery pre-approved by the plan, it didn’t pay. The couple have been left with $129,000 in unpaid medical bills in collections.
In recent years, several types of health coverage arrangements that are not subject to key state or federal consumer protections have proliferated and are often marketed as alternatives to traditional health insurance. One type of these arrangements is a health care sharing ministry. While health care sharing ministries (HCSMs) are careful to say that they aren’t health insurance, many sure look like it. Unlike insurance, they offer no guarantee that medical bills will be paid, even for covered services. Enrollees may believe that they are enrolled in health insurance, only to find that the product they have purchased provides little if any coverage for their needs.
Texas allows HCSMs to operate today on the honor system, without any oversight. That approach is no longer working in an industry with growing revenue, membership, and complaints. HB 573 is a step in the right direction, though could be made stronger. If legislators want to protect consumers in this market, which is drawing more scrutiny for consumer confusion and harm, this bill needs to stay strong as it moves through the legislative process.
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