EDITORIAL: Obamacare manages to make bad deals look good

Jan. 11--THANKS to Obamacare's high prices and limited provider networks, many people are now pursuing alternatives that, in some cases, may leave them unable to pay major medical bills. Chalk up another tally mark under "Affordable Care Act,

unintended consequences of."

Buried in the text of the Affordable Care Act is a

provision exempting members of health care sharing ministries from the law's insurance mandate. Those ministries provide cost-sharing arrangements that aren't technically considered insurance since payment is not guaranteed. They are free from insurance regulations, although some operate much like traditional

insurance companies. Their costs typically are far less

than current insurance rates.

The exemption applied only to nonprofit ministries in existence before 2000, probably to limit participation. But the high price of Obamacare policies is now driving thousands more to consider cost-sharing arrangements. Before the federal law's enactment in 2010, there were around 200,000 people participating in cost-sharing ministries. Today, it's estimated around 500,000 people do so.

While some cost-sharing ministries have good records, there are high-profile cases in which participants in certain ministries were left financially devastated, including in Oklahoma.

One such ministry, Medi-Share, was sued in 2007 by Andy Bowman, an Oklahoma pastor who claimed his request for financial help with more than $27,000 in bills after heart complications was denied. Bowman and Medi-Share ultimately settled out of court.

Karen Niles, a homemaker and a church volunteer in Blackwell, endured worse. Beginning in 2003, Niles and her husband paid Medi-Share monthly shares, or premiums, ranging from $450 to $500. But after initially paying for treatment of a brain tumor, Medi-Share cut off payment in 2008. The issue went to binding arbitration, where Medi-Share prevailed as Niles' health worsened.

In 2011, Niles' husband, Robert, told the Associated Press he would not recommend Medi-Share to anyone. "They have done their damage on me and my wife."

In 2007, Lincoln County District Judge Joe Vassar ruled Medi-Share was "involved in the offering of contracts for insurance" and wasn't exempt from Oklahoma Insurance Department regulation. Subsequently, the department issued a cease-and-desist order preventing the ministry from accepting new members.

"If it looks like a rose and smells like a rose, then it's a rose," then-Insurance Commissioner Kim Holland told the Tulsa World. "We are going to treat Medi-Share like an insurance company."

Holland noted Oklahoma law at that time allowed religious organizations to facilitate efforts to share members' medical costs by publishing the names and contact information of those willing to enter such an agreement.

Basically, people could make direct contributions to help other people pay medical bills, and an organization facilitating those transactions could charge an administrative fee without being subject to insurance

regulation.

In contrast, Holland noted in an interview with the Journal Record that Medi-Share "was collecting premiums, paying claims, charging late payments, putting money in an offshore account and taking 25 percent off the top."

(Subsequent changes to state law allowed Medi-Share to continue operating in Oklahoma.)

Not all cost-sharing services are as controversial, but cases like those noted above have not been confined only to Medi-Share. However, Obamacare's mandates have reduced consumer selection and increased insurance prices dramatically, even as consumers are ordered to buy those policies. This has increased interest in cost-sharing ministries.

It takes a lot to make an outfit with Medi-Share's troubled history look appealing, but President Obama found a way.

___

(c)2016 The Oklahoman

Visit The Oklahoman at www.newsok.com

Distributed by Tribune Content Agency, LLC.