hcs vs medicaid expansion

Health Care Sharingvs.

Medicaid Expansion

An Update to the Presentation forThe Philanthropy Roundtable’s 2014 Donor Event

“Private Alternatives to the Welfare State”Salt Lake City, Utah

8 October 2014

Health Care Sharing involves:• Christians helping Christians• Pay their medical bills• WITHOUT health insurance

Health Care Sharing: Christians helping Christianspay their medical bills without health insurance

How does HCS work?A scenario


Three National Christian HCS Ministries• Charitable organizations• 501(c)(3) non-profit corporations

A few other regional and growing HCSMs

Several very small church-based HCSMs (mostly Mennonite)


1,000 medical events


Let’s say, this month, one ministry has 1,000 medical events totaling $10 million.


They divide the medical bills among the tens of thousands of households in its ministry.


The ministry mails a newsletter with an insert providing the name of another Christian family in the ministry to mail a check for their medical bills.

A check… … from us … … to you!

Along with …


One family sends another family a check for their medical bills.They send a get-well card and pray for them.

Name

AmounttoShare AmountReceived DateReceived Card

1 JohnDoe

$150.00

2 Buster&BethBullock

$300.00

3 Max&PeggyHiggenbottom$370.00

4 PercevilleHammond

$150.00

5 Alex&SallyJackson

$300.00

6 SeanDonnelly

$150.00

7 FelicityPfizer

$150.00

8 JackStone

$179.23

9 Hector&HollySinkovich

$300.00

10 Harold&PriscillaJones

$394.62

11 Al&CynSutton-Frazier

$300.00

12 BoHughes

$150.00

13 MichaelRawlings

$150.00

14 Kenny&MichelleBurpo

$300.00

15 La'QueshaBrown

$150.00

16 Hank&BuffyBorne

$394.62

17 BillyBob&NancyRuthCutter$300.00

18 MoonunitZappada

$150.00

19 MiguelGonzaga

$150.00

20 MaryMargaretSprissler

$179.23

21 SusannaFreshwater

$150.00

22 MarySmith

$150.00

23 RobertoRuiz

$150.00Total

$5,117.70


Let’s say you have a $5,000 medical bill. The ministry will divide it between, let’s say, 23 randomly selected families in the ministry. You get a checklist.

30 to 60 days


From the time you submit your bills to a ministry, it will usually take between 30 and 60 days for you to receive checks from other families to help pay your bills.

HCS is already an alternative to Medicaid expansion for the working poor

60% of one HCSM’s participants qualify for government housing

72% of HCSM participants’ incomes are at 400% of FPL or lower

44% of HCSM participants’ incomes are at 200% of FPL or lower

HCS vs MedicaidHealth Care Sharing: Christians helping Christians

pay their medical bills without health insurance

HCS promotes fiscal responsibility

Kaiser Family Foundation:2015 Average Annual Family Premiums

= $17,545

One HCSM’s 2015 Average Annual Sharesfor a Traditional Family of Three or More

= $4,860

$17K vs $5KHealth Care Sharing: Christians helping Christians

pay their medical bills without health insurance


Let’s dive into the weeds.

HCS can fit into the budgetof the working poor

Family Size 2014 FPL Income HCS Income %Single < 26 $11,670 $1,680 14.4%Single 26 + $11,670 $2,160 18.5%Single Parent < 26 $15,730 (1 child) $2,400 15.3%Single Parent 26 + $19,790 (2 children) $3,000 15.2%Family w/Parents < 26 $23,850 (3 children) $4,260 17.9%Family w/Parents 26 + $27,910 (4 children) $4,860 17.4%

2014 FPL Incomes from http://aspe.hhs.gov/POVERTY/14poverty.cfm


HCS can fit into the budgetof the working poor

Family Size Various Incomes HCS Income %Single < 26 $10/hr = $20,800/yr^ $1,680 8.1%Single 26 + $12/hr = $24,960/yr^ $2,160 8.7%Single Parent < 26 (1 child) $15/hr = $31,600/yr^ $2,400 7.6%Single Parent 26 + (2 children) $18/hr = $37,440/yr* $3,000 8.0%Family w/Parents < 26 (3 chdn) $20/hr = $41,600/yr* $4,260 10.2%Family w/Parents 26 + (4 chdn) $25/hr = $52,000/yr* $4,860 9.3%

^ Less than 225% of FPL; * Less than 200% of FPL


HCS can fit into the budgetof families with lower incomes

Median Family Income & Income Limits for Government Housing

STATE MFI (US = $63,900) 1 person 3 persons 4 personsAL = $54,100 Low Income $30,300 $38,950 $43,300

HCS Annual $ 2,160 $ 3,000 $ 4,860(18 in $50Ks) % of Income 7.1% 7.7% 11.2%

UT = $65,300 Low Income $36,550 $47,000 $52,250HCS Annual $ 2,160 $ 3,000 $ 4,860

(17 in $60Ks) % of Income 5.9% 6.4% 9.3%

VA = $77,500 Low Income $43,400 $55,800 $62,000HCS Annual $ 2,160 $ 3,000 $ 4,860

(10 in $70Ks) % of Income 5.0% 5.7% 7.8%

HCS amounts for persons 26+. MFI & Low Income amounts from http://www.huduser.org/portal/datasets/il/il14/State_Incomelimits_Report.pdf


HCS engenders personal responsibility

To participate in a HCSM, you must agree to live by these four life-style requirements:

• Sex within Biblical marriage• No drunkenness• No illegal drugs• No smoking


Policy Successes

Participants in HCSMs were granted one of nine exemptions from the individual mandate in the Affordable Care Act.

Fully 30 states have granted a safe harbor to HCSMs:AL, AK, AZ, AR, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MI, MS, MO, NE, NH, NC, OK, PA, SD, TX, UT, VA, WA, WI, WY

ACA


Policy Future of HCS

At the federal level, Congress has been considering a bill that would expand options for participants in HCSMs.• It would expand the options

for people opening a Health Savings Account to include participation in a HCSM.

• Over the years, other federal bills have included similar language, showing support.

• It has had 100+ co-sponsors.


Major Points

Health Care Sharing involvesChristians helping Christians pay

their medical bills without health insurance.

HCS is already an alternative toMedicaid expansion for the working poor.

Participants in a HCSM are exemptfrom the ACA individual mandate.

A bill in Congress would tie HCS to HSAs.

$5K


For more information on Health Care Sharing

Go to www.healthcaresharing.org

E-mail me directly: joe at hirejagconsulting.com

Call me directly: 804.467.1880


hcs vs medicaid expansion

Documents