Download - HCS vs Medicaid Expansion
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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
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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
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How does HCS work?A scenario
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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)
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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1,000 medical events
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
Let’s say, this month, one ministry has 1,000 medical events totaling $10 million.
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Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
They divide the medical bills among the tens of thousands of households in its ministry.
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Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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.
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A check… … from us … … to you!
Along with …
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
One family sends another family a check for their medical bills.They send a get-well card and pray for them.
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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.
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30 to 60 days
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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.
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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
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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
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Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
Let’s dive into the weeds.
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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.
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance
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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
Health Care Sharing: Christians helping Christianspay their medical bills without health insurance