Kentucky, Health Insurance, and Religious Freedom

Another writer here and elsewhere, I determined from my research, has been writing about the recent decision of a Kentucky judge regarding Kentucky MediShare, a religious based entity that, for a “premium,” helps people with their medical bills. I applaud them for their efforts. They have been in existence now for 18 years and only now is Kentucky lowering the boom on them.

Users pay a monthly premium that is then used to pay for the medical expenses of another member. When that premium-payer then has their own medical expenses to deal with, the community reaches out to help them cover those expenses. There is no contractual agreement between premium payers and MediShare to pay medical bills. Based upon household income and family size, the person pays anywhere from $500 to $10,000 yearly to MediShare. In effect, this payment, known as the Annual Household Portion, is akin to a deductible. Seniors are also afforded a special program called Senior Assist. Designed to cover gaps in Part A and Part B Medicare coverage, payments are limited to copayments, deductibles, hospitalization, stays in nursing facilities and urgent care at out-of-county providers.

In effect, it is a faith-based community of strangers coming together to help one another with medical costs. Those who become members must “prove their faith.” They do this in the following ways: (1) regularly attend church and actively support a ministry; (2) complete a Statement of Faith and have a “verifiable relationship with the Lord;” (3) believe Biblical doctrines with respect to the purity of the human body; (4) not engage in extramarital or premarital sex, and; (5) not use tobacco, drugs, or alcohol. Obviously, some of these requirements would automatically exclude certain groups. For example, the sex requirement states that it must be within the context of a Christian marriage. This eliminates the gay community and, one would suspect, possibly non-Christian groups. The group also states specifically that it will not cover abortions.

MediShare is not technically an insurance program. They operate as a non-profit and the money received is never MediShare’s money. They are not required to pay any bill/request, nor do they keep any cash reserves on hand. At first glance, it appears to be a charitable organization that acts very much like an insurance program. Because it appears like an insurance program, Kentucky is requiring it to be regulated as one. However, those regulations would negate many of the aspects that make the program unique, specifically and most importantly, its religious character.

Personally, although I worry about the state’s intrusion into a religious organization- serious in and of itself- I also worry about the state’s intrusion into the right of free association. If Christians, or Jews, or Muslims, or practitioners of Wicca for that matter want to band together to help defray each other’s medical expenses, they should be allowed to do so free of government interference and regulation. If the Christian group accepts and disburses money only to Christians as they define the term “Christian,” then so be it. Likewise, Jews, Muslims and witches can do the same. Also, nothing is preventing the LGBT community from doing the same. My only worry is the possibility of fraud. Obviously, regulations which enhance “purchaser” awareness and knowledge would be acceptable, but the principle of caveat emptor- let the buyer beware- should be controlling here.

In an odd sense, I also understand the state’s interest. If it walks like a duck and talks like a duck, chances are it is a duck. The program looks suspiciously like a medical insurance program, but without a contractual policy. That is kind of scary. But conversely, this is a Christian organization with an 18-year history of no problems or complaints. Perhaps there are; I just couldn’t find any in my research. Hence, it strikes this writer kind of funny as to why now the state seeks to regulate it. Did its popularity cause it to pop on the state’s radar screen? Are there, in fact, complaints against it with the state? Also, unlike a charity where one donates out of the goodness of one’s heart or in response to a religious doctrine and nothing is expected in return, there is an expectation of return here. Although I rue the day the government intrudes in the operation of religious organizations and charities and dictates to them who receives their largesse, I am also leery of those who would hide behind and use religion as a pretext to defraud well-meaning contributors. It would not be the first time it has happened.

It will be quite interesting to see how this plays out in court litigation. If nothing else, it illustrates an old, yet unique and innovative way to help those in need with medical bills. It would be interesting to see what percentage of anyone’s medical expenses are paid for by MediShare. Obviously, if at or near the 100%, it is de facto medical insurance (and subject to state regulation). If, on the other hand, it is used to fill in the gaps left open by regular insurance policies, then it may be more correctly viewed as a charitable receipt. I hope the motivation behind the recent state action is not some half-hearted attempt at political correctness in the name of eliminating discrimination. This is an interesting subject and one worthy of watching developments.