Vermont lawmaker introduces bill to require reporting from health-care sharing plans

Montpelier — Representative Connor Casey introduced H.102, a bill that would require health-care sharing plans that operate in Vermont to report enrollment numbers, financial data and marketing materials to the Vermont Department of Financial Regulation.

Casey, a representative from Montpelier, said the measure is not a ban and would not restrict religious participation but would “simply require them to report very basic information, to Vermont's Department of Financial Regulation,” so consumers can make informed decisions.

Supporters say the plans, often called health-care sharing ministries, resemble insurance in marketing but “they're not insurance,” Casey said, and are not subject to the same regulatory oversight. He told the committee that Colorado’s recent transparency law showed there are “at least 11 healthcare sharing ministries or plans in Vermont right now,” but that the true number could be higher.

The bill would require reporting of how many Vermonters are enrolled, how much money the plans collect from Vermonters, how much — if any — of that money goes to members’ medical costs, and copies of contracts and marketing materials. Casey said the goal is transparency: “Right now we're in the dark on these organizations.”

Casey read a contract excerpt into the record as an example of the kinds of exclusions he found: “we do not share needs for ******** transmitted diseases including, HIV virus and or AIDS. When contracted through irresponsible behaviors such as sharing needles for legal or illicit drugs, it is the member's responsibility to explain how the disease was contracted.” He said nationwide reporting showed the sector collected more than $1 billion in revenue in 2020.

Jennifer Carby, legislative counsel, told the committee that health-care sharing plans are not health insurance and are “acknowledged in the ACA” (the federal Affordable Care Act) but are not required to provide minimum essential benefits. Carby recommended the committee might also hear from the Department of Financial Regulation, which she said has taken regulatory action involving some of these organizations.

Mike Fisher, Vermont’s health care advocate, said the advocate’s office receives calls from Vermonters whose coverage problems turn out to involve “scam insurance” or health-care sharing administrators that did not pay claims. Fisher said data collected through a registration requirement would help identify the scope of the problem.

A commenter who identified a family Medi-Share payment experience described a large hospital bill that was negotiated down and then paid by Medi-Share: “The original bill was like 450 something thousand, because we were self pay and they knocked down to, like, dollars 175,000... We had to pay $5,000 deductible, but they were willing to pay that.” Casey acknowledged that there may be legitimate actors in the market but said oversight is appropriate: “Maybe there's some really good people putting this together, but I think it should be regulated just like any other health insurance.”

Committee members asked how the registration would work and how often reporting would be required. Casey said the bill would align reporting frequency with that required of insurance companies, describing it as an annual filing. He also said he had alerted the attorney general’s office and hoped DFR would be able to use the filings to identify operators doing business in Vermont.

H.102 was introduced to the committee for discussion. No vote was recorded at the meeting; the bill’s requirements, enforcement mechanisms and any fees or costs to registrants were described in general terms but not finalized at the session.