Last week tonight, John Oliver delved into U.S. Medicare – specifically, health care sharing departments, organizations in which members share health care costs that are often billed to wrong like Medicare, centered on a common religious faith and ready to be misused.
“The most important thing to know about shared health care ministries is not just that they can be cheaper than health insurance, which they can,” Oliver explained. “Is that they are also do not health insurance. Typically, these are non-profit organizations where people with religious beliefs, usually Christianity, agree to help each other cover other people’s medical bills.
Shared health care ministries have been around for decades, typically for island communities such as Mennonites or Amish. But their popularity exploded after 2010, when the Affordable Care Act, popularly known as Obamacare, included government departments as an insurance mandate exemption from the law. Some health care sharing departments, such as Liberty Healthshare, advertise specifically to a conservative, law-hating audience, with ads on right-wing fringe networks and at the Conservative Political Action Conference.
At their best, shared health care ministries can offer heartwarming stories of generosity and community care. “People who genuinely care about each other sound better than our current system, which is to get sick, have insurance decline coverage, then hope Debra Messing retweets your GoFundMe,” Oliver joked. “And it seems more personal to send $ 500 a month to a stranger in need than to a [insurance] company that looks like someone who made up a word after getting a shitty hand at Scrabble, ”like mega-vendors Aetna, Cigna or Humana.
But there are “significant drawbacks” to shared health care ministries, Oliver continued, ranging from “worrying to disqualifying.”
Following Obamacare’s exemptions, the number of people who depend on shared health care ministries to pay for medical bills has skyrocketed from 200,000 members to over one million today. “And while the HCSM will insist that they make it clear that they are not health insurance, many appear to be doing everything possible to masquerade as as much insurance as possible.”
Since government departments do not actually provide insurance, they do not have to comply with government regulations and therefore may deny coverage for pre-existing conditions or essential services such as addiction treatment or mental health care.
More importantly, they can deny coverage based on character criteria, “which means you can be denied coverage for just about anything,” Oliver explained. Many HCSMs will not pay for health care for complications from smoking and will refuse LGBTQ members. Liberty Healthshare guidelines state that an applicant “shall conform to … a Christian way of life”.
As for the guarantee of actually paying the bills, Oliver pointed to a video from Liberty CEO Dale Bellis titled “Will My Bills Get Paid?” in which he reassures: “It does not depend on a written contract where one can continue if someone does not send the amount of his share; it is truly a contract written in our hearts.
“Oh, that’s right, it’s a contract written on your hearts,” Oliver unmoved. “Figuratively, of course, because it’s literally not a contract. And as for his claim that Liberty has managed to share 100% of the medical bills for “every qualifying need” given that, as we’ve seen, they can deem any need ineligible for whatever reason, this sentence is essentially as meaningless as their heart problem. non-contractual.
“And on top of all that, there is the practical question of how exactly you pay for your care as a member,” he continued, especially as members rely on HCSMs to reimburse after paid the cost in advance. “And if you’ve ever waited for your friends to come to Venmo after paying for dinner,” said Oliver, “you know the refund process can go very badly.”
“Look, globally we need to do more in this country to lower the cost of health care,” Oliver added later, and although he advocates for a single payer system, “this clearly won’t happen if early. So, in the meantime, I get the allure of cheaper health insurance. The problem is, it’s not that – it’s not insurance at all. And states owe it to themselves. less pass laws that make sure people know what they are getting into with HCSMs and force them to allocate funds properly.
But some states are moving in the opposite direction, such as Florida, which in 2018 relaxed its restrictions on HCSMs from requiring participants to be members of the same religion to requiring that they “share a common set of ethical or religious beliefs. “.
“It could be pretty much anything,” Oliver said. “At this point the bar for entry is so low that anyone could become an HCSM. And the reason I know that is, “he added, pointing to himself,” whoever did it.
Three months ago, he explained, Last Week Tonight launched his own church “Our Lady of Perpetual Health”, a spin-off of the fake church of the show “Our Lady of Perpetual Exemption” founded in 2015 as a satire of tax exemptions for churches. . The Florida-based Joke Church now has its own shared health care ministry, Johnnycare, whose founding “was awfully easy to do.”
Nonetheless, Oliver introduced viewers to the ministry, with an offer to go to www.freedomfromhealthcare.org and “see if you qualify to send us money and get next to nothing in return”.
“As close to nothing as it gets,” former SNL cast member Rachel Dratch said as fake pastor Wanda Jo.
“And to be clear,” Oliver added: “We shouldn’t be able to get away with this.”