It's why Robert Daniel Apodaca Jr. invests $345 a month into a medical bills payment program for Christians that's most easily explained by what it is not: It's not insurance. Not regulated by state or federal watchdogs. Not bound by contract to cover his family's medical costs.
Instead, the program called Medi-Share is sort of a cooperative of the devout that allows Apodaca, a born-again Christian, to help others pay for surgeries and treatments with the faith that when someone in his family is sick, they'll return the favor.
"In a sense, it's trying to do God's work by helping your neighbor," said the 23-year-old truck driver who lives in a small rented home in Ventura with his wife and 4-year-old daughter. "It says in the Bible to help someone in need."
Medi-Share is a controversial health-care-sharing ministry of 50,000 Christians, including about 100 people in Ventura County. Families in the 19-year-old program pay an average of $280 a month. The money from one member is used to pay for bills for someone else. When Apodaca's contribution is used, he receives a prayer message of thanks.
"It's awesome," he said.
To be eligible, members must sign a statement of beliefs including that the Bible is without error and Jesus was born of a virgin mother. They vow not to engage in sex outside of marriage and not to smoke, abuse alcohol or use illegal drugs.
Medi-Share provides coaches and programs aimed at improving health. Designed for what an administrator calls big burdens, it doesn't cover regular checkups or preventive care. People with cancer or type-2 diabetes are not covered for pre-existing conditions.
Coverage guidelines are set by votes of members. Abortion, birth control and sexually transmitted HIV are not covered because of the group's religious beliefs.
Because the program is voluntary and run by members who can pull out whenever they want, leaders say it's not insurance, meaning they're not governed by state or federal insurance regulators.
A U.S. Department of Health and Human Services official said provisions of federal health care reform that mandate coverage for pre-existing conditions and preventive care apply only to health plans. Medi-Share officials said their program is not a health plan.
The reform law also includes a provision that members of health care ministries are exempt from the 2014 mandate that requires people to obtain insurance -- an exemption Medi-Share uses as a publicity pitch.
The claims of protection from state insurance regulations have sparked a decade of court battles in Kentucky, where the state Supreme Court ruled the plan is insurance and issued an injunction that regulators allege the organization is ignoring.
In California, state officials offer little feedback. A California Department of Insurance spokeswoman declined to comment. A California Department of Managed Health Care representative said officials were unfamiliar with Medi-Share.
Others, like Paul Newman, president of the Ventura County Association of Health Underwriters, can't suppress their reactions."Wow," he said, expressing concern at the exclusions in coverage and lack of regulatory oversight. "I'd be frightened as hell to have something like that."
Apodaca joined Medi-Share several months ago after hearing about the program on Christian radio. He's used it once -- to cover his daughter's vaccinations that cost between $350 and $450. He paid $115 as sort of a deductible, and Medi-Share paid the rest.
For him, the program is a way to save money from the $450 premiums he was paying for private insurance. More importantly, it's a way to practice the beliefs that changed his life.
"When I heard Christians share each other's medical bills, that was a light bulb," he said. "I knew my money was going to benefit someone else."
Based in Melbourne, Fla., Medi-Share started in 1993 as part of a nonprofit called Christian Care Ministry. It's one of a handful of ministries that offer Christians a less expensive way to cover costs by applying biblical principles.
"It's kind of like how a church works," said the Rev. Howard S. Russell, CEO of Christian Health Care Ministries in Ohio, drawing a comparison to the contributions sent by 14,000 people and then distributed to pay members' health care costs. "They take an offering and the offering is dedicated for different purposes."
He said his organization differs from private insurance companies sometimes ensnared in allegations that profits skew their motives.
"You don't see those abuses in the health-sharing ministries," he said. "The attitude and the spirit of those who are participating are not looking to see if they can beat someone but if they can assist someone."
Medi-Share has covered liver transplants and bills as high as $900,000, said Tony Meggs, CEO of its parent group, Christian Care Ministry. The organization limits spending to $1 million a year for a member's medical bills and $5 million for a lifetime.
With contributions that function like premiums and out-of-pocket expenses similar to deductibles, the plan sounds like insurance. It isn't, Meggs said, because there's no guarantee medical bills will be paid. There's no contract. And members' payments are not tax-deductible either as charitable contributions or medical expenses.
Outsiders familiar with health-care sharing worry about the lack of oversight.
"The people putting in money aren't very protected if something goes wrong or someone's acting in a disingenuous way," said Dylan Roby of the UCLA Center for Health Policy Research.
The ministries target people desperate for an alternative to insurance and who have devout religious beliefs, said Mila Kofman, a research professor at Georgetown University Health Policy Institute. She worries about Medi-Share's lack of a guarantee.
"For consumers, it can be devastating, especially someone who signs up thinking they're going to get help for medical bills," she said.
Meggs said the program wouldn't be able to maintain its exempt status if it built up the reserves needed to cover all care.
"Don't get me wrong, I can totally see how this wouldn't make sense for some people," he said. "For others, it does make sense."
Dick and Deidre Howlett turned to Medi-Share when they moved into their daughter's home in Oxnard after working 10 years as missionaries in Asia.
He's 61. She's 65. Both have pre-existing conditions. They wanted a program that would offer protection against health care bills and supplement Deidre's Medicare.
They pay about $450 a month for Medi-Share, which Dick believes is much less than private insurance rates. Their pre-existing conditions aren't covered, and he had to lose an inch off his waistline before being formally accepted into the program.
But he's been assigned a health coach. He's lost about 20 pounds. He feels as if Medi-Share cares about him.
As Dick sat in a garage on a warm afternoon, he thought about the lack of guarantees and the absence of government insurance regulation. It doesn't bother him. He believes Christian organizations are in general governed by the word of God, which calls for justice, grace and mercy.
"I'm not saying it couldn't happen," he said of problems, "but I would just as soon myself deal with a Christian organization than a secular organization."
(c)2012 Ventura County Star (Camarillo, Calif.)
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