H.B. 255 Health Care Sharing Ministry Amendments: transcript

I do. So I won't go through the whole presentation since we did it last time, but, uh, since I'll just bring you up to speed. Since then, I've reached out to the industry stakeholders and to Senator Musselman, and I think we've now landed with amendment number two in a place where, um, at least everybody can live with it. And so, I'm not gonna say everybody necessarily loves it, but I think we're, we're at a place where we're good. So I'll say that much and then you guys can ask me any questions. Yeah. And just to follow up on that, um, I did speak to Senator Musselman about it. He's presenting in another committee, but he did indicate that he had gone over that with you and he was comfortable with it.

I'm gonna make a motion to, uh, uh, amend number two, a amend amendment. I make a motion that we move amendment number two. And is it in, it's in Representative Abbott, in Senator Abbott's, or Representative Abbott's name.

Yeah, I just wanted to compliment the house sponsor for working with Senator Musselman. I probably would've voted for the bill last time, but, um, I think collaboration and compromise is a good thing. And so I just, uh, wanted to give a shout out to Representative Abbott. Thank you.

No, I'll Waive Senator Ipson. I'll waive. Okay.

Uh, no. I'm just happy to answer any questions you Have. Okay.

Hi, uh, Joel Noble with Samaritan Ministries. I am coming to you from Peoria, Illinois, and I just want to add my thanks to Representative Abbott. Um, I did testify yesterday, um, yesterday I was opposed, um, as Representative Adam said, Adam Abbott said he reached out to us, uh, worked with us, and, um, we, as I think he said it correctly, uh, we can live with amendment number two. And, uh, it solves the concerns that I brought up yesterday. And, um, we no longer have opposition to the bill.

Thank you very much. My name is Seth Stewart. I'm representing myself and I'm from American Fork. And, uh, I have an objection to this bill on the grounds that, uh, it does still require, you know, the amended version to help requires healthcare care sharing min ministries to, uh, state a disclaimer which gives off the, the feeling that, uh, or expectation from a potential client or consumer, that it's not going to cover or pay their, their health bills, uh, irrespective of whatever the agreements or terms of that, uh, that health sharing contract might be. And that just seems needlessly invasive into private contract space. And that, uh, this would put the thumb on the scale to basically say, no, you should really go with, uh, you know, uh, an insurance plan that's approved by the state government. Um, I would much rather that we just stay out of that space and allow people to, uh, get their own consumer information, have informed consumer choice. Uh, and I, I understand that the argument is likely that this is accomplishing that, but I think there's already a communication medium in place to guarantee that the, uh, end user gets what they're agreeing to. So with that, I'll urge our position to the bill. Thank you.

Senator Ipson. Thank you Mr. Chair. I too wanna come in. Representative Abbott, I think you showed how the process works here, and thanks for making it, making it work like it. Should I make a motion that House Bill 2 55 first substitute as amended pass out with a favorable recommendation?

Representative Abbott. Thank you. So we have a statute in our state that recognizes Health Share ministries as a, you know, a legitimate, uh, thing. And in our current statute, we do require a notice somewhere in applications and guidelines that states certain things. This kind of adds to that notice requirement and brings us more in line with what other states are doing with Health Share ministries, because what it does is it adds the words prominently written notice. And, uh, basically what it requires is the notice needs to state this is not insurance. We are not obligated to pay your medical bills. Uh, the reason we're putting that notice in is it's actually factually true. And when people get a health share ministry, I think most understand that they're not purchasing insurance and there's no legal obligation to pay their medical bills. But some people think it is insurance but is not. And so then they get a surprise when they get a big medical bills. So that's what this bill does. And the only thing I'll add to that is I have been in contact again with the Health Share Ministries, and they've made a request that I think is reasonable. Um, I've asked for an amendment, but it hasn't popped up, but I think we can just do it by a voice amendment. And that is to strike the word website because their point being this goes across all states and they don't want to, uh, it's hard for them to make a state specific requirement on the website. And so that's the, that's the change I'd ask for.

I'm happy to answer any questions. Does

Yeah. I'm just curious, uh, representative, what do other states do in this regard?

Uh, there's not all other states, but most other states that actually recognize these. There's a lot of states that don't even recognize Health Share ministries, but those that recognize them require a notice that is substantively similar to this.

Okay. Um, but maybe not identical. Okay. Thank you.

There we go. Alright, Go ahead Joel. Alright, Thank you very much, uh, chair Vickers and members of the committee. Uh, thanks for having me today. My name is Joel Noble and I am coming to you from Peoria, Illinois. And I'm here representing Samaritan Ministries, one of the largest sharing ministries among the 1 million Americans using healthcare Sharing Ministries nationwide. Uh, Samaritan has been approved and accredited by the Healthcare Sharing Accreditation Board since 2022. And for over 31 years, Samaritan has been serving our members as we bear one another's burdens through healthcare sharing. And I've been blessed to serving in the healthcare sharing field for over 24 years. Unfortunately, as currently written and amended, we would not be able to support House Bill 2 55. We appreciate that the state of Utah has explicitly recognized that the state insurance code, that healthcare sharing ministries were not insurance. The Utah code already includes the requirement that healthcare sharing ministries include on or with every application and guideline materials. A disclaimer that includes among other requirements that a ministry state that we are not insurance and each participant is always personally responsible for their expenses. In total. That current disclaimer says in one form or another, three different ways that we are not Insurance House Bill 2 55 would add a new second verbatim disclaimer requirement saying the similar things. But additionally, on websites and all advertising material, we do appreciate the sponsor's desire to protect against consumer confusion and ensure clarity that consumers are clear. The healthcare sharing ministries are not insurance and are over 31 years of existence. To our knowledge, Samaritan Ministries has never had a member complain to any Department of Insurance or any other regulatory agency in any state or any other consumer advocacy group. This is in large part to our best practices, including ensuring that potential members are clear about what a healthcare sharing is and is not. Including that we are not insurance bad actors not abiding by these same standards are likely not fulfilling the current disclaimer requirement. And adding new additional requirements will only burden the quality of ministries like Samaritan. Nevertheless, we have worked with the sponsor on alternative language, and again, I thank him for the amendments that he's already, uh, proposed. Uh, and that was a, uh, vast improvement over where the bill started. I got a question for sponsor. The requirement now to additionally include the verbatim words we are not obligated to pay your medical bills will actually add consumer confusion given that this language is not accurate. Accurate in the context of healthcare sharing ministries, as it is the members rather than the ministry organizations themselves who share or pay one another's medical expenses. Additionally, given the new inclusion of advertising, If I could get you to wrap up, we've got some time constraints. Uh, Absolutely. So while overall we don't see the need for this, um, the request that we would ask if the bill does move forward is to remove the phrase, we are not obligated to pay your medical bills. And then also add the phrase in substance. The word in the phrase in substance would be, um, consistent with the vast majority of other states that have, uh, disclaimers. And it would, uh, not require us then to revise all our existing advertising material to incorporate this new verbatim statement. Okay.

Well, yeah, if I could just ask for the sponsor. I, uh, in reading the text, it does seem to land a bit harsh. Um, and I'm wondering if you're open to amendment. I I just was just playing with words before the witness, um, even testified. And I thought, because it seems almost, almost like you're pushing back against this industry and that, uh, to, to, to paint a negative stance. And I think something a little softer like this is not insurance and payment of medical commences is not guaranteed. Something along those lines might land a little less, a little more appropriate and more and less abrupt in, in the face of, of what I use this, these, these, these, this is insurance and I know it's not insurance, but it worked really well for me. And I, I'm afraid this kinda statement is gonna scare individuals off from using it. And when, when sometimes it's the only choice you got and it's a viable choice. So I'm just wondering if you're open to rephrase ology of, of that term. So I do have an amendment that just popped up and it does have the substantially similar that he requests in that amendment. Um, I want, my experience in speaking to several people who have had this type of insurance is, it works great as long as you don't have a catastrophic injury with 500,000 or a million dollars in medical expenses. That's, that's probably fair. Yeah. But I, And that's where I think people need to understand that, hey, if, if I just get sick three times a year and go to the doctor, this is great. This is fantastic. But if I want something that's going to pay for my baby that's been in the ICU for six months, maybe I need something different. Right. Mr. Mr. Chair, if I may, that's not my question. My question is, does this, does this sentence land too harsh or not?

Well, I think if the way it's written now, we are all, we are not obligated to pay your medical bills is factually accurate. And they say, well, it's the, it's the members that are obligated. No, they're not obligated either. Nobody's obligated to pay your medical bills in these plans. So I think it's factually accurate. Now I get what you're saying. Maybe something softer would be good. I think the word substantially similar, maybe help them do that. But I do think people need to go into this with their eyes wide open and know what they're getting. I, I don't mind people getting health share ministries, but when they think that they're getting a promise to pay, that's not fair to them.

Thank you, Mr. Chair. Thank you. Um, okay.

Sure. Thank you, Mr. Chair. Can you hear me all right? Yes, go ahead. Okay. Mr. Chair, members of the committee, uh, my name is Randy Hulk Grin. I am the Executive Director for the Alliance of Healthcare Sharing Ministries. I've been in this role for all of three weeks. Uh, so, uh, pretty new, but I'm also a former member of the United States Congress, uh, and also a member of the Illinois Senate, Illinois, Illinois House of Representatives. Uh, and also I would say maybe most importantly for this discussion have been a proud member, my family and I of Samaritan Ministries. While I was in Congress, uh, I became a member of Samaritan Ministries, dropped, uh, the Affordable Care Act, uh, and have loved, uh, this ministry and this work. It's been wonderful for my family. But I speak on behalf of the Alliance today, representing the interest of five national ministries, including Samaritan that we're members of, of, of, and we are in support of Samaritan's comments and urge the legislators to amend this bill in line with the language that's been submitted, which provides necessary flexibility while still accomplishing the ultimate goals. Again, so grateful for the work that you all do. I know your hard work and, uh, just wanna say how much I appreciate what you do and any way that we can be helpful at the Alliance, please let us know. Thank you, Mr. Chair.

Well, I'll, I'll just chair, I'll look for you for some advice here. Right here. I'm a no right now I'm a no un unless we can look to amend. So I, I would, I would be interested in moving on the next side of agenda to see if we can work on it. Otherwise, I'd be a No. Okay.

Fine. We can come back if you, I'd love to come back tomorrow 'cause I'll work with Rep or Senator Musselman and see if we can resolve our issues. But, uh, I I think that's appropriate.

All right, go ahead. So, when people, uh, we, we obviously have health insurance in our state, but there's a new thing that's come up in, I dunno how long it's been around, but not super long, called Health Sharing Ministries. And our code is very clear that that is not insurance and it, so it's not regulated by our insurance code. And in fact, in order to qualify for that, it cannot be an obligation by the company to pay medical bills of one of the participants. Um, I've had, uh, several experiences with people who were surprised by that and didn't quite understand the difference between insurance and a health sharing ministry. So what this bill does is it requires health sharing ministries to, um, place on basically advertising materials or guidelines or pamphlets or websites. Uh, a prominently displayed notice that this is not insurance and they are not obligated to pay medical expenses. And, uh, I, the industry did reach out to me, and one of their concerns was that in many cases, not all, but in many cases, health sharing ministries don't even have contracts with their members. And so my use of the word contract in the bill was not very accurate. And so I've got a sub on there that I think fixes that issue. And so that's my bill. I'm happy to answer any questions.

or ano ano ano, Thank you. I'm pretty sure that a more detailed reading of this would answer my question, but I I prefer to just ask you, um, what are the, the, what does this notice or notification actually look like? Can it be an email? Does it have to be posted in writing? Um, does that make sense what I'm asking?

Yeah. So it depends how they communicate with a person. If it's on a website, then it's gotta be on the website. If it's in an application, it's gotta be on the application, uh, guideline. And it just says other materials and advertising materials. So really any, it just depends on the format that they disseminate the information, where they're advertising or explaining their program. It's just gotta be on that. So on a website, it's electronically appears on the website in a prominent way.

Thank you, Madam Chair, very much in, sorry, Dave Gessel with Utah Hospital Association. We're very much in support of this bill. Wish it might go farther, and let me explain why. Um, unlike normal insurance where you have a contract between the patient and his insurance company and the insurance company, oftentimes with providers, hospitals, and others that define the pay, how payment will be made, this is set up where there really aren't contracts with providers or with the, uh, subscribers or people using these. And so there is often confusion, uh, where, for example, uh, the health ministry might offer to pay the hospitals 20% of what is billed and, uh, which would, you know, that's not anywhere near what the cost is. And obviously insurance does some discounts, but that's been a problem particularly for our rural hospitals. And secondly, uh, the confusion with the subscriber, whoever's involved with this, they often think that, uh, health sharing ministry is, has a contract with providers. And so they're surprised when they have to pay the whole bill or the vast majority of the bill that the health ministries, uh, didn't pay. Now, I can't speak for all them. I'm sure some are fine and they do this, but, uh, the concerning thing here is there's really no, uh, as you mentioned, the representative mentioned in his testimony or, uh, introduction to Bill, there's really no, uh, legal binding of anyone in this other than oftentimes the patient and or the hospital gets stuck with the, the full bill or however they can deal with that. It's totally at the discretion of the health ministry, whether they will pay any or all of the bill. And that hurts their own people that are, that are relying on them. And it also hurts providers. So we appreciate this and, uh, uh, continue maybe to look at this in the future. Thank you.

Hi, I am Delaine England, and I just, I'm not really speaking against the bill, but I'm definitely not speaking in favor of it because I had Christian Health Share Ministries for many years. Being self-employed, we always had to get our own insurance. So I had it from different providers, but, and my children that are self-employed also have di not necessarily Christian Healthcare. They have Medi-Share and different ones. And I just can't even tell you how much I loved it. It was amazing. And every company that I have dealt with at all, or even got a quote from, they make it so crystal clear. They make it really clear at the top. So I'm not sure we need to force them. I don't really think they have a big issue with it 'cause they're doing it already. So I just wanted to share that and kind of speak in favor of 'em. Thank you.

I have a comment and then I'll make act, uh, take action. Okay. Okay. I just wanted to say that we are also frequently surprised by bills from insurance companies. When we have insurance, we often don't know what we're going to end up paying. And my daughter's had some closeup and personal experience with that in the last year. And that health shares and cooperatives are very helpful to a lot of people.

That said, I would like to make a motion that we favor substitute. What's That? We need to adopt a substitute, right? Oh, That we adopt. What, which sub? Sub one. Substitute one. What's the bill? Number Two. HB 2 55. Mm-hmm.

Okay. I would like to make a motion to favorably pass out HB 2 55.

Yes. Thank you. So I'll just, uh, add a couple things. I think, uh, the public comment made a good comment. Many of these health share ministries are already doing this, and so I applaud them for doing that. Many states that allow these plans require them to put a notice similar to what we're requiring here. And so, uh, I don't, that may be part of the reason they're doing it, or they may just be doing it because they want their customers to understand. But I think there are some, well, I know there's some that aren't doing it because I've seen their materials and it's not in there. So this just gets down to that level and says they're all going to do it. But at the end of the day, this doesn't really stop or discourage Health Share Ministries. It just makes sure that the customer knows what they're buying and they're still allowed to buy it. And they, they can make that choice, but we just want 'em to know what they're doing. Thank you. All right.

Uh, Representative Eliason. Uh, given the lack of opposition and simply being a disclosure bill, I'd make a motion we put on consent with the permission of the sponsor.

Sorry, What was that? Do You wanna on consent? Oh, Um, I don't know. Do you think it's, It's your choice?

Um, I think after the discussion we had about consent, I'd probably say no because some people I withdraw my motion. Next item of the agenda. There's only two on consent Right now. Don't say I didn't offer.

Thank you. HB 2 55, um, affects our health share ministering code. So we are one of the few states that actually recognizes Health share ministries and provides a framework in which they can operate in our state. Um, one of the parts of our existing codes states that in order to qualify as a health sharing ministry, um, they cannot be insurance and they cannot be contractually obligated to pay medical bills. What we don't have in our statute, which most states that have these that recognize them have, is a requirement that they prominently display some sort of warning on their website or advertising materials or even their guidelines, uh, stating that this is not insurance and it's not a contract or obligation to pay medical bills. So what this bill does is it adds that requirement to our existing code. Um, I've spoken or I've corresponded with the health share administering lobby, and they gave me some suggestions on how to make this work better and I've incorporated those into this sub. And, and so that concludes my presentation and I'm happy to take any questions.

Thank you. I think this is a good bill because it just lets the consumer know what they're getting. They, they need to understand what they're purchasing and it doesn't restrict Health Share ministries. They're still allowed to operate. People are still allowed to use them, but they just know what they're getting.