HCSMs – Sham Heath Care “solutions” that are scamming lots of people

There existed an organization called Sharity Ministries. This previously operated under the name Trinity Healthshare, Inc. They were what is known as a health care sharing ministry (HCSM).

A what?

OK, it works like this.

HCSMs generally pretend to be health insurance providers, but they are not. The idea is that a group of people who have a common religious belief pool their resources and share health care costs. This concept has a long history and goes right back to the early 1900s when it started with individuals within the Amish and Mennonite communities. They pooled their money and used the available common resources to assist anybody who needed help.

Now, this all sounds fine, except of course when it is not. There are many problems within this model. I’ll get into that shortly, but first, let’s briefly cover what has happened with Sharity Ministries, Inc.

Attorney General Bonta Takes Legal Action Against Sham Health Care Sharing Ministry

On Jan 12, 2021, the California Attorney General, Rob Bonta, put out a formal press release announcing that they were launching a lawsuit against both Sharity and the family behind them. The link to that press release is in the title above.

Sharity Ministries, Inc operated by selling health plans to Christians. This resulted in them having a stream of income that was as much as hundreds of millions of dollars flowing in each and every month. The scam was literally a movie plot – they declined almost all claims and kept 84% of all that revenue. Those that had bought into the plan were crushed with medical debt they could not pay.

But this was Insurance, don’t they have an obligation to pay?

Nope, not at all, and that is one of the huge problems with these HCSA plans, they are not health insurance plans.

Sharity was set up by The Aliera Companies (Aliera) and the Moses family, so this lawsuit is following the money and going after them.

California Attorney General Rob Bonta is quoted as follows …

“Aliera preyed on consumers who, in many cases, thought their monthly payments were being used to help others who shared their faith and religious beliefs. Instead, Aliera and the Moses family funneled its members’ payments into their own pockets, When members suffered medical emergencies, their problems were compounded by Aliera claiming it had no obligation to pay medical costs. Aliera’s sham business is unlawful and our lawsuit seeks to ensure they are held to account to pay the price for the Californians they lured in and cheated.”

Sharity Ministries themselves had already previously filed for Chapter 11 bankruptcy back last July. That was due to an onslaught of state lawsuits and investigations. This latest update is CA stepping over the protection that Chapter 11 offers an organization and sees them going after the people behind what is clearly a scam.

The big challenge here is that this is not just about one very bad HCSM. The core problem is that the entire Health Care Sharing Ministry concept is deeply flawed.

Health Care Sharing Ministries (HCSMs) are a huge problem

When you are the main story on John Oliver’s Last Week Tonight, then you know that what you are doing is a huge issue for consumers.

Back in June 2021, Health Care Sharing Ministries featured for all the wrong reasons.

John flags up some of the deeply challenging problems here …

  • Because of a loophole in the 2010 ACA law, HCSM members are exempt from the tax penalties outlined in the Affordable Care Act, the net impact is that HCSMs have been very successfully targeting conservative audiences. Some of them even sponsored CPAC.
  • HCSMs are not health insurance. They often pretend that they are, but they really are not. Because they are not insurance products then the laws that regulate insurance products do not apply. For example, they can, and do, place restrictions on coverage for pre-existing conditions and nothing can stop them from doing that.
  • There are many essential services that they also do not cover – for example treatement for substance abuse, or mental health care.
  • Some will even exclude treatement for Obesity and also Autism
  • Some exclude regular checkups and vaccinations
  • Some also set maximum limits – for example $250,000
  • Since these are religious groups, they can use moral judgements to deny coverage. This enables them to deny coverage for more or less anything at all – If you smoke or you are a same sex couple, don’t even think about applying. As for anything related to alcohol or abortion, nope, no coverage.

In other words, if you don’t share a specific set of beliefs and don’t hate gay people or fat people, then it’s not for you.

I kid you not. Some applications explicitly state that you must comply with a “Christian” lifestyle.

Having said all that, even if you tick all those boxes there is still no guarantee that your medical bills will get paid. There is no contractual obligation for this to happen. John Oliver highlights that one provider claims on their website that they successfully shared 100% of medical bills for any eligible need. The catch is that they can more or less deem any need to be ineligible and so their “guarantee” is utterly meaningless.

BBB has received thousands of complaints about Liberty HealthShare and other HCSMs not paying.

At about the 13 min mark in the John Oliver clip, he covers Aliera and Sharity. As I said, if you are being highlighted by John Oliver, then it really is generally not for a good reason.

He highlights that they have been utterly ruthless in denying people coverage. To illustrate this he uses the story of a 10-year-old with a brain tumor. Aliera refused to pay the $325,000 because it was “out of network”. After flagging it up on primetime news they paid. In other words, if you don’t have a 10-year-old to shame them into paying on the TV news, then you will probably not get paid.

Yes, traditional insurance companies also have horror stories, but there is a degree of legal protection with them that simply does not exist with HCSMs.

One last thought

On the stage at CPAC, an HCSM plan was promoted as a way to stick it to the ACA. The truth is that HCSM’s are in fact a way to stick it to yourself.

You basically get scammed into believing that you have health care coverage and then discover that when you really need it, you don’t.

HCSMs might indeed look like lower-cost health insurance. The problem is that it is not insurance at all – caveat emptor, quia ignorare non debuit quod jus alienum emit.

In other words, no deductibles, no claims, no contracts, and lots of bills for you to pay. Simply send them your money and get nothing in return except a worthless promise.

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