Zion HealthShare, according to CEO Nathan Udy, encourages its members to share their burdens with one another. Zion says it welcomes all comers regardless of faith, but many of its peer companies in the health share industry note that their core imperative is set down in Scripture. \u201cCarry each other\u2019s burdens,\u201d Paul the Apostle says in Galatians 6:2, \u201cand in this way you will fulfill the law of Christ.\u201d<\/p>\n
Zion aids this cause by giving people a chance to pay monthly into its collection. Then, when a member faces a medical expense\u2014a broken arm, say, or a hospital stay\u2014that member can submit a sharing request to the community to draw on this pool of money to help with the bill. \u201cRather than functioning through policies and premiums,\u201d Zion tells prospective members, \u201chealth shares are built on the concept of shared responsibility.\u201d<\/p>\n
Founded in late 2018, the St. George, Utah-based group has grown rapidly in recent years, with reported annual revenue jumping tenfold from 2020 to 2024\u2014the latest year on record\u2014to $93 million. It reports 1,222 members in Oregon and 75,000 members nationwide, spanning nearly every state.<\/p>\n
One reason Zion is not in literally every state, however, is because a few years ago it hit a snag. Although the group describes itself as \u201cthe affordable alternative to health insurance,\u201d the Washington State Office of the Insurance Commissioner determined that it was in fact just plain health insurance\u2014albeit health insurance operating without a license, with benefits that did not satisfy basic insurance regulations. <\/p>\n
One fairly important benefit it did not provide: any requirement that the collective pay for a member\u2019s medical treatment. <\/p>\n
Zion countered that it was not, in fact, insurance, and that it is quite clear about this point in its guidelines. \u201cZion HealthShare is not an insurance program, but members share major medical costs with one another as a community,\u201d Zion wrote in one disclaimer to prospective members. Zion also told members it \u201chas shared all eligible medical expenses of its members to date\u201d even as it cautioned that the \u201cguidelines do not create a legally enforceable contract between Zion HealthShare and any of its members.\u201d <\/p>\n
Time went by. Authorities ruminated. Then, a few weeks ago, the Washington State Court of Appeals issued its verdict. \u201cNo one can change the nature of insurance business by declaring in the contract that it is not insurance.\u201d The words in the Feb. 5 ruling were drawn from decades-old precedent. Today, Zion, like many similar health shares, no longer accepts members in the state of Washington.<\/p>\n
Oregon is a different story. Of the eight health share arrangements (at least) that Washington\u2019s insurance office has effectively chased from the state since 2020, most continue to accept members here. In the same time frame, the Oregon insurance office says it has taken regulatory action against two such groups. <\/p>\n
To some, this speaks well for Oregon. Health shares, they argue, have much to recommend them. They appeal to the devout believer who does not want to pay into insurance plans that fund acts that offend them. (Zion, for example, notes that expenses for an abortion are \u201cineligible for sharing.\u201d) They also appeal to relatively healthy people who want something that is like health insurance, but on the cheap. <\/p>\n
From this perspective, Washington is the nanny state, while Oregon wisely stays out of its residents\u2019 private affairs. \u201cIt\u2019s your responsibility as a consumer to do your due diligence to your research,\u201d state Rep. Emily McIntire (R-Klamath Falls) said at a hearing on the matter last year. <\/p>\n
From another vantage, however, the split screen suggests an Oregon insurance commissioner\u2019s office that is a bit drowsy on the watch\u2014or at least conflict averse\u2014and which might stand to learn something from its zealous neighbors to the north.<\/p>\n
Before his recent retirement, the Washington state insurance commissioner for two-plus decades was Mike Kreidler. <\/p>\n
In going after health care sharing arrangements for operating as unlicensed insurers, he saw himself as protecting consumers from misleading, dangerous, and aggressive marketing of a highly complex and important product. And yet, he says, the offending health shares often quickly reconstitute under a new name. And at a time when health insurance premiums are skyrocketing, he says, health shares are pitching themselves with verve.<\/p>\n
\u201cI see a lot more advertising being done than I saw before,\u201d Kreidler told WW by phone the other day, as he was taking a stroll. \u201cI think they\u2019re trying to pick up people who are desperate, who want to have some kind of coverage.\u201d<\/p>\n
A few thousand miles across the country at Georgetown University\u2019s Center on Health Insurance Reforms, JoAnn Volk has been making a similar observation. \u201cWhen premium goes up for [Affordable Care Act] coverage, we see much more marketing of non-ACA options, including health care sharing ministries,\u201d she says in a video call.<\/p>\n
She adds, \u201cI see new names of ministries all the time.\u201d<\/p>\n
There is a history here. Certain religious communities, like Mennonites, have a genuinely deep-rooted tradition of rejecting certain modern financial products, like health insurance. The 2010 Affordable Care Act, which set down a financial penalty for those who did not purchase health insurance, averted a direct clash with this tradition by carving out members of \u201chealth care sharing ministries\u201d\u2014a term it defined by several parameters, including the somewhat arbitrary quality of having existed continuously since Dec. 31, 1999.<\/p>\n
Some groups that meet that criteria still exist. Many that emerged post-ACA clearly don\u2019t\u2014a fact that has considerably muddied the waters since many of them, like Zion, claim the identity all the same. (\u201cWe don\u2019t look to government definitions for our identity,\u201d said a spokesperson for the Alliance of Health Care Sharing Ministries, which represents five major health shares. The spokesperson noted the ACA requirement that a qualified group must have been sharing continuously since 1999 \u201cobviously has nothing to do with whether an organization is an actual health care sharing ministry.\u201d)<\/p>\n
One appeal of health shares\u2014that they might get their members off the hook of having to buy ACA health insurance\u2014dwindled somewhat in 2019, after President Donald Trump reduced the penalty for not having insurance to zero. <\/p>\n
But another appeal remained: Health shares were health insurance-like plans\u2014often charged with righteous purpose\u2014and without the cost or hassle of health insurance rules.<\/p>\n
It is easy to forget the pre-ACA health insurance landscape, Volk says, recalling a period when health insurers could reject people for having preexisting conditions, and were not required to offer many of the basic benefits they do today. Health care sharing ministries hark back to that bygone era: \u201cEven though all those things make it seem just like insurance, there\u2019s no obligation to pay, ever,\u201d Volk says.<\/p>\n
The problem is that this \u201cnot paying\u201d tendency sounds to many people a lot like the behavior of actual health insurance companies. The distinction is largely meaningless to consumers, Volk says. Still, she insists the daylight is actually quite significant. <\/p>\n
\u201cOne never has to pay,\u201d she says. \u201cOne has to pay unless they\u2019ve said it\u2019s not medically necessary for you\u2014and an external party agrees. That\u2019s a very, very different thing.\u201d<\/p>\n
Some people have learned this the hard way. One of the two health share ministries Oregon has taken action against is Aliera. In 2019, the state alleged, an Oregon resident filed a complaint that the company denied a claim for an emergency room stay, leaving a $79,595 bill that an ACA insurance plan would have had to cover. <\/p>\n
But in Oregon, that enforcement action has been an outlier. <\/p>\n
The Oregon Division of Financial Regulation defends its work. \u201cOur process, like many states, is complaint- and resource-driven,\u201d division spokesman Jason Horton tells WW. \u201cWe cannot comment on current caseloads, and our activities speak for themselves. Our goal is to always get companies to be in compliance with Oregon laws.\u201d<\/p>\n
Notably, Oregon, unlike many states, including Washington, has no \u201csafe harbor law\u201d exempting at least some health care sharing arrangements from normal insurance regulation. Still, the Oregon insurance office has said its hands are tied. Last year at a hearing, a state DFR official outlined the office\u2019s view on the matter: Most inquiries it receives on health care sharing arrangements \u201crelate to issues such as not paying claims or paying claims only partially or very slowly or providing what is alleged to be poor customer service,\u201d he said. \u201cSince these arrangements are not insurance, there\u2019s often little to nothing we can do in those situations.\u201d<\/p>\n
Washington, by contrast, seems to have more closely scrutinized health shares\u2019 claims to not be insurance. And perhaps as a result, it has fewer of these arrangements. Judging by the latest data, at least 12 health share arrangements exist in Washington, compared with at least 19 in Oregon. Still, public statistics on the industry\u2019s market share are collected by only a couple of states, like Colorado. <\/p>\n
Last year, a group called \u201cSecular Strategies\u201d suggested Oregon Rep. Rob Nosse (D-Southeast Portland) propose a bill for the state to require health shares to report similar information. It would have placed no additional burden on the arrangements, but after bringing it forth, the health committee chair quickly learned the issue was spicier than he knew, as Republican colleagues balked and talked of their own experiences mulling health sharing plans, and an Alliance of Health Care Sharing Ministries official descended on Salem to pillory the proposal. <\/p>\n
The bill died. But as Nosse pointed out at the committee hearing, the prevalence of health care sharing groups raises core questions about the role of government in the private lives and moral decisions of the public. In court in recent years, Zion HealthShare raised this issue too, when it argued that Washington\u2019s requirement that it get an insurance license would have a coercive effect on its reason for being: to encourage its members to share their burdens. <\/p>\n
The Washington state court saw things through a different prism. If Zion got licensed, the judges noted, it would be required to cover preexisting conditions and a wider array of medical services and procedures. Yes, this would mean higher monthly contributions from members. But, the court noted, it would be consistent with Zion\u2019s ostensible purpose.<\/p>\n
\u201cBeing subject to Washington State insurance law,\u201d the court wrote, \u201cwould encourage greater sharing of medical burdens with one another.\u201d <\/p>\n","protected":false},"excerpt":{"rendered":"Zion HealthShare, according to CEO Nathan Udy, encourages its members to share their burdens with one another. Zion…\n","protected":false},"author":2,"featured_media":594340,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[64,63,137,500],"class_list":{"0":"post-594339","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-au","9":"tag-australia","10":"tag-health","11":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/594339","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=594339"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/594339\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/594340"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=594339"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=594339"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=594339"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}