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Florida to examine faith-based health care

By Jennifer Liberto, Times Staff Writer
In print: Sunday, April 27, 2008

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TALLAHASSEE — The health care program is called Medi-Share, Biblical Healthcare Solutions.

With a pastor's nod and a monthly fee between $53 and $570, nonsmoking, church-going Christians get their medical bills paid — except for things like breast implants, abortions or fertility treatment.

Yet, on nearly every other page of its benefits pamphlet, Christian Care Ministry Inc. says it's not health insurance, because it doesn't guarantee bills will get paid.

With 50,000 clients nationwide, the Melbourne-based organization is the biggest of at least three such groups that have grown in the wake of skyrocketing health insurance costs. About 47-million people are uninsured nationwide.

But so far, these groups have operated with little oversight.

This week, the Florida Legislature is expected to consider whether Christian Care Ministry and other such religious groups should be exempt from oversight by Florida's Office of Insurance Regulation. The proposed exemption has been tucked into the governor's priority health care package (HB 7081, SB 2534).

"They are a religious organization that comes together, pooling together their resources to cover each other's medical bills. How about that?" said Rep. Aaron Bean, R-Fernandina Beach, the House's health care budget chief. "They're not insurance; leave them alone."

But some critics, such as Rep. Loranne Ausley, D-Tallahassee, say they aren't so sure it's a good idea for the Legislature to give such groups a way to operate without oversight.

"If they're not insurance, why don't they just let OIR make that determination?" Ausley said. "We have a process."

Christian Care has been around for 15 years, growing from a staff of three who worked out of a garage office into a company that now employs 150, mostly in Florida, says Christian Care president Robert Baldwin.

The way it works is that participants send a monthly check to the company, which creates different accounts for each family that participates. When a family needs a bill paid, the company moves the money between accounts, Baldwin says.

Baldwin says the company is different from an insurer, because it doesn't take on risk and doesn't promise to pay bills. However, most bills get paid, Baldwin said.

To qualify for the program, participants have to agree with the company to submit to binding arbitration to settle payment disputes, "not in a secular court," according to a Christian Care pamphlet.

Christian Care takes in roughly $50-million a year, including $4.4-million in Florida, Baldwin says. He says the company has "shared" $350-million in medical expenses over its history. The IRS doesn't require religious organizations like Christian Care to file financial statements, the same as with other nonprofits.

Baldwin also says that Christian Care spends about 23 percent of what it collects on administration, or roughly $11.5-million annually. Charities that spend 15 percent or less on administration usually garner the best ratings by watchdog groups. Most Florida health insurers spend between 28 and 40 percent on administration costs, which includes commissions, according to the OIR.

Included in administrative costs is money Christian Care has spent in several states battling regulators in court or lobbying for exemptions like the one it's pursuing in Florida.

Montana kicked the company out. Illinois and Nevada are among states that have told the company to stop operating, but Christian Care said it's appealing the orders. About 10 states, including Wisconsin, Pennsylvania and Kentucky, have approved exemptions to allow such groups to continue unregulated.

Florida's Office of Insurance Regulation checked out Christian Care in 2003, when Gov. Jeb Bush was encouraging faith-based alternatives. The office decided the program operated in a "gray area" and made no decision on whether the group should be regulated, according to a 2003 OIR memo. Regulators waited to see if they received complaints. They haven't, said OIR spokesman Tom Zutell.

Earlier this year, the Department of Financial Services, under Chief Financial Officer Alex Sink, launched an investigation into Christian Care, which prompted the company to take its case to the Legislature. Sink's office took sworn testimony from company executives in February. Sink's spokeswoman said the office doesn't comment on pending investigations.

In Tallahassee, the company has hired well-known insurance lobbyists, including Mark Delegal, who also lobbies for State Farm. The proposal to exempt religious groups from insurance regulation has solid support among Florida House Republicans.

It's not clear how the proposal will fare in the Senate. But Sen. Mike Fasano, R-New Port Richey, said he plans to try to get the religious exemption on some more bills.

"It's a great opportunity for people to have health insurance but understand what the limits are," Fasano said.

When asked about the issue last week, Gov. Charlie Crist said he was unfamiliar with the company but found the situation curious.

Jennifer Liberto can be reached at (850) 224-7263.

Times researcher Carolyn Edds contributed to this article.