Faith-based coverage could threaten ACA stability

Some say healthcare ministries unfairly attract healthy customers
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The trend of Americans turning to health ministries instead of insurance providers may put stress on the Affordable Care Act's stability, according to an article from the Wall Street Journal.

Ministries in continuous operation since at least Dec. 31, 1999, are exempt from the Affordable Care Act rule that allows participants in eligible ministries to avoid fines for not buying insurance. That exception was primarily allowed to satisfy relatively small religious groups that argued that their nonparticipation was a matter of religious freedom, the article states. Generally, health ministries cover the medical bills of any individual who agrees to abide by a Christian lifestyle and attend church on an ongoing basis, FierceHealthPayer has reported.

But now, some insurance commissioners are rasing concerns about health ministries because they operate outside the insurance system and aren't regulated by states. They say that ministries attract more healthy customers, since they can offer plans that are 30 percent lower than private insurers, thus removing these healthy individuals and leaving private insurance companies to care for the older and sicker population, according to the WSJ. Most ministries don't always share bills for certain pre-existing conditions, whereas the ACA requires insurers to cover anyone regardless of their past or current medical history, the article points out.

Health ministries have also faced legal challenges. Former officials of an Ohio ministry were ordered by a jury in 2004 to pay more than $14 million for spending money for medical bills on real estate, vehicles and the living expenses of an exotic dancer, the WSJ says. And members of another ministry have filed lawsuits in Montana, Illinois and Oklahoma, claiming particular medical bills that should have been shared were not. 

In some states, insurance commissioners have even gone so far as try to shut down their state ministries' operations, but efforts have been blocked by state legislatures, which back the right of ministries to operate without interference.

To learn more:
- read the Wall Street Journal article (subscription may be required)

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