("LAST WEEK TONIGHT" THEME PLAYS)
Moving on. Our main story tonight
concerns health care.
The field responsible for repairing organs,
treating cancer, and removing foreign objects from rectums,
which have recently included...
...which, credit where its due,
is the most promising advancement in cat hiding places
since under the dresser.
Access to health care is a big problem in America,
and one of the key reasons is that health insurance
is often linked to employment. Why is that the case?
Well, because we do it wrong.
There is a right way to do it, but we don't do it that way.
We do it the wrong way.
And this is a particular problem at the moment
because employment is still down...
...from its pre-pandemic level. All of which means
that many are struggling to find health care coverage right now.
So they might be intrigued
if they stumble on an ad like this.
My health care costs were gonna double this year.
It was down to health care or my student loans.
I found a better way.
It's neighbors helping neighbors.
It's freedom from insurance.
At Liberty HealthShare, we support each other
and keep health costs down.
We're changing the way you're paying for health care.
This is the way it should be.
We're all in this together. Together.
Well, hold on, because I'm not sure how "together" you all are.
What I saw there was a bunch of people together
with warm lens flares, and then one weird older man
very much on his own in black and white.
He's in a slightly different thing,
and we're not going to say why, but on some level,
I think we all know.
That ad is for something called a health care sharing ministry.
And if you haven't heard of them before,
you may have come across one and not even realized it.
Because they've been growing fast in the U.S.
And the key phrase in that ad is "freedom from insurance."
Because the most important thing to know
about health care sharing ministries or HCSMs,
isn't just that they can be cheaper than health insurance,
which they can,
it's that they're also not health insurance.
Generally, they are non-profits
where people who share religious beliefs,
agree to help cover each other's medical bills.
Here's a heartwarming story about what one of them looks like in practice.
BOB STEDMAN: We're praying for a young lady named Kimberly.
JASMINE VIEL: Bob Steadman and his family are praying
for someone they've never met.
She had a shunt installed in her brain.
VIEL: They've also prepared a card with a check for 561 dollars.
STEDMAN: ...to bear her burden by sending them some money.
VIEL: A scene like this plays out here once a month.
It does take a measure of faith to do it.
We are sharing. This is so different
than what we're used to in our society.
People actually looking out for each other
does sound better than our current system,
which is get sick, have insurance decline coverage,
and then hope Debra Messing Retweets your GoFundMe.
That's great, Debra, but did you donate? Did you?
Did you, Debra?
And it does feel more personal, sending 500 dollars a month
to a stranger in need than to a company that sounds
like someone made up a word after getting a shitty Scrabble hand.
Perhaps that is why the local news team who covered
that story seemed so moved after it ended.
I mean, can you imagine being that person
and getting the check in the mail?
You know, not knowing that someone was gonna help you
and then suddenly you have all this help?
Right. It's all about faith, isn't it?
Faith that it's gonna get paid. Faith in God.
-and it's just amazing. -It's incredible.
Yeah, of course, they're into this shit.
Faith? Strangers? Coming together?
Throw in a runaway dog who found his owner
in the hospital even though he'd never been to the hospital,
and you've got yourself a schedule one local news thirst trap.
And HCSMs are definitely an alternative.
But as you've probably guessed because you're only learning
about them on this show, not "What if John Oliver
Was Somehow Less Angry, Less English,
and Had Jack Ryan Money?"
there are also some significant drawbacks,
which, depending on the company in question,
can range from the disquieting to the disqualifying.
So tonight, let's talk about health care sharing ministries,
what they are, what they do and more importantly,
what they don't do.
And the first thing to know is HCSMs have actually existed
in the United States for decades,
traditionally serving small, insular communities
like Mennonites and the Amish. However,
the 2010 Affordable Care Act included a loophole
that exempted uninsured people from paying the tax penalty
if they were a member of an HCSM.
And that was clearly immediately appealing
to anyone who wanted to opt out of Obamacare.
In fact, some HCSMs, like Liberty HealthShare,
one of the biggest ministries, have specifically targeted
a conservative audience. Liberty has run ads
on The Blaze, and also sponsored CPAC.
In fact, remember that famous moment
when Trump molested the flag?
The Liberty logo was an eyewitness to that crime.
And Liberty even made its sales pitch directly
to the CPAC audience during panels like this one.
If you want the government to take care of you
and you think they do a great job doing it,
health sharing is not for you.
If you wanna stick it to 'em, sign up for Liberty HealthShare.
Okay, on a list of the worst sounds known to man,
self-satisfied CPAC laughter has to be right at the top,
beat only by weeping kitten
and mother's orgasm.
Now, that Affordable Care Act loophole did try to put
some limits in place to keep things from getting out of hand.
It stated that your ministry or crucially...
But unfortunately, that predecessor detail
left room for exploitation.
because new ministries simply started affiliating themselves
with previously existing churches.
Take one called Trinity HealthShare.
It was founded in 2018, which is, and this is true,
after 1999, but it argued that it still qualified
because it derived its existence from the Baptist church...
...which is obvious bullshit.
It's like me claiming that this show has been around
for 13 billion years because the big bang was also
a bright expanse containing extremely dense material.
That's just not how anything works.
So a loophole that was intended to be small got pretty big
and even bigger once Obamacare's individual mandate
stopped being enforced during the Trump years.
And the result of all of this was that the popularity
of these ministries exploded,
from an estimated 200,000 members a decade ago,
to more than a million today.
And while HCSMs will insist they make it abundantly clear
that they're not health insurance,
many do seem to go out of their way to make themselves
appear as insurance-like as possible.
For a start, they're sometimes sold through insurance brokers
alongside actual insurance plans.
And while the Obamacare marketplace
offers plans in four metal categories:
bronze, silver, gold and platinum,
a company called Altrua offered plans in gold,
silver, bronze, and copper, rebranding them last year
to diamond, emerald, sapphire, and ruby.
Although it's still pretty clear what they're trying to do there,
very much blur the line, while also throwing
some extremely unfair shade at ruby,
the objective goat of the cardinal gems.
She's red, known for her flaws, and responsible
for the most iconic slippers in the history of cinema.
Eat your fucking hearts out, sapphire and emerald,
because you could literally never.
But while these HCSMs may have the optics of insurance,
there are some very important differences.
For a start, They don't have to abide
by laws governing insurance products.
Meaning there's nothing stopping them
from placing restrictions on coverage for pre-existing conditions.
Which is exactly what they do.
And not only that,
many won't cover services considered "essential"
under the ACA.
Like treatment for substance abuse,
or mental health care.
In fact, Altrua excludes those,
and also treatment for obesity or autism.
And Samaritan's "Classic" plan
has a list of non-qualified items
including Routine, Maintenance,
Stabilized, Preventive, and Wellness Care.
That is everything,
from regular checkups to vaccinations.
And even for eligible expenses,
the most that can be shared for a given need is $250,000.
Which probably explains their full name
"Samaritan," not the good one though,
just a random Samaritan who might well leave you to die
in the middle of an abandoned road."
And we haven't even gotten
to one of the biggest excuses HCSMs can use to deny coverage,
And that is morality.
Because that means you can be denied coverage
for basically anything.
This is a program of the Christian Care Ministry,
and people who smoke or same-sex couples
need not apply.
The program also won't pay
for illnesses related to alcohol, abortion,
or other lifestyle-related choices.
I need to know that I'm not gonna be paying for someone else
who's decided to sit on the couch and eat bonbons all day.
Wow, that is harsh.
But I will say that judgmental tone
is very much in line with how these ministries operate.
Do people really deserve healthcare coverage
if they eat junk food or don't exercise or are gay?
Just fix it!
Eat a carrot, go for a run, rub your penis or vagina
on somebody else's vagina or penis, respectively.
It's really not difficult!
And this is a pattern across HCSMs.
Liberty's materials say,
"an applicant must comply with a Christian lifestyle."
And among the exclusions on Samaritan's "Classic" program,
you'll find that they might pay for treatment for an STD, but...
not if it was contracted by sex outside of marriage,
and that the member
has to explain how the disease was contracted.
Presumably, the hotter the story,
the more money you get for ointments.
Vanilla missionary shit isn't gonna get covered here, bud.
You better have gotten gonorrhea from an earlobe
if you want Samaritan's attention.
But sweeping moral judgment isn't the only leeway
that these organizations have.
Because they're voluntary associations,
you have no guarantee that your bills will get paid.
Although, to hear a founder of Liberty HealthShare tell it,
you've really got nothing to worry about there.
Just listen to him reassure people in a video on their website
titled "Will My Bills Be Paid?"
We've had a successful history of sharing medical bills, 100 percent,
for every eligible need ever submitted.
So, it doesn't depend upon
a written contract where we can sue each other
if someone doesn't send their share amount.
It's really a contract written on our hearts.
It's a contract written on your hearts.
Figuratively, of course.
Because literally, it's not a contract.
And as for his claim there that liberty successfully shared
a hundred percent of medical bills
"for every eligible need," given, as we've discussed,
they can deem any need ineligible for any reason,
that phrase is essentially as meaningless
as their cardiac non-contract.
And on top of all of this,
there's the practical matter of how exactly you pay for your care
as a member.
The HCSM process typically is you're told to present yourself
Then, when you get your bill,
the expectation is that you bargain down
the cost of your care as much as you can,
then, pay the bill yourself.
Then, submit your bills to the ministry for reimbursement.
And if you've ever waited for your friends to Venmo you
after paying for dinner,
you know that the reimbursement process can go very wrong.
Participants in Liberty-- you know, the one with the "heart contract"
have found payments can be slow, to nonexistent.
TV REPORTER: In the past three years, Tiffany Schultz
with the Wisconsin Better Business Bureau
says the BBB has taken more than 500 complaints
about Liberty HealthShare.
Many with similar stories.
One claiming 90,000 dollars in outstanding medical bills
that were pre-approved.
Either the consumer is out the money
and hasn't been reimbursed,
or they're ending up going to collections."
That's not great.
And while Liberty claims that 2019 was a particularly difficult year,
or that they're proud of the improvements they've made since then,
it is worth noting that Liberty's members
still seem pretty active on the Better Business Bureau website,
where they've logged 304 complaints in the last 12 months,
which is a lot, especially when you consider
that Cigna, a massive insurer, has just half that amount,
while having 15 times the members.
And imagine having more people complain about you
than about Cigna,
a company whose logo
is a cartoon man standing in a field
as his head explodes
from dealing with their customer service.
And unfortunately, in most states,
a complaint to the Better Business Bureau
is basically all the recourse you have.
And these ministries have worked very hard
to keep accountability at bay,
successfully lobbying for so-called "safe harbor laws"
in more than 30 states,
ensuring that they can operate safely outside
of insurance regulations.
And to see just how much you can get away with,
it's worth looking at a company called Aliera,
which has been heavily involved
with a number of health-sharing ministries over the years.
First, one called Unity,
Then one called Trinity, which now goes by Sharity.
Although, those names sound less like a healthcare organizations
and more like characters in a religious-themed Captain Planet knockoff.
When their powers combine,
they get cancelled after two episodes.
Aliera presents itself as merely an administrator
but it's intricately connected
to the ones it works with, and very much by design.
Just six weeks after Trinity was incorporated,
it signed a deal with Aliera
stipulating that Aliera would have
exclusive ownership rights to the membership roster,
and was the sole party developing and marketing the plans,
including the HCSM component.
So, Aliera's relationship with Trinity, is basically
this guy's relationship to his alien costume.
He can claim he isn't technically the costume,
and that's true.
But the costume doesn't really do anything without him.
And customers in multiple states
have claimed that Aliera and its ministries
have been ruthless in denying coverage,
wielding "morality clauses" hard.
When one member was attacked and knocked unconscious outside a bar
and taken to the hospital with serious injuries,
including a skull fracture, cervical spine fracture,
and intercranial bleeding,
Aliera denied her claims,
stating her injuries were "self-inflicted,"
and citing their guidelines, including the line,
"follow spiritual teachings on the use or abuse of alcohol,"
which I'm pretty sure is the benevolent advice
Jesus himself would have given under the circumstances.
And incredibly that's not even the worst story
of a rejected claim involving Aliera
JUSTIN GRAY: Ten-year-old Lola Grae Segars is healthy
just four months after brain surgery.
On September 11th,
she was rushed from the local ER in Greene County by ambulance
to Children's Healthcare Scottish Rite,
where doctors removed a softball-sized brain tumor.
It was just amazing, the care...
GRAY: But last week, came the bill
from their health plan, Aliera Companies.
GRAY: Aliera says Children's is out of network
and won't pay the 325,000 dollar bill.
We had a life-threatening emergency.
They failed us and her.
They were denied reimbursement for a child
who had a softball-sized tumor removed from her brain,
which is incidentally, exactly the kind of immoral
behavior I'd expect sharing ministries to classify
as fucking disqualifying.
Now, Aliera claims that that family's issues
were ultimately resolved.
But only after that story was featured on the news.
And it shows just how little recourse you have,
that if you don't have a child you can get on TV to shame
the company into action, you could be shit out of luck.
And look, traditional insurance companies
also have their share of horror stories
when it comes to denial of coverage.
But there are important differences here,
not just in the level of protection you have
when that happens, but in the degree
of financial accountability.
Because while the ACA requires actual health insurers
to spend no more than 20 percent of money
on administrative costs, therefore leaving at least
eighty percent for care, there's no such requirement
for HCSM'S. And you can probably tell where this is going.
Because investigations have found
that out of every $100 a Trinity member paid in premiums,
only $16 went towards paying medical expenses,
with the rest being kicked up to Aliera.
And paying out 16 percent of the money you take in
for coverage is a lot different than paying out 80.
Because 80 percent makes you think, "Wait, why exactly
do we have insurance companies?"
Whereas 16 makes you think "Is there a crime happening
to me right now, and if so, why does everyone seem
okay with it?"
And when a local news reporter caught up with
the head of Aliera to ask her about its reluctance to
pay out claims, her response was not particularly reassuring.
REPORTER: Do you have any apologies to the members
-who believe their claims-- -Oh, my goodness.
-ought to be paid -We're not--
-we're not a health-- -and they're not paid?
we're not a healthcare-sharing ministry, Mr. Strickland.
We only administer on behalf of the, of the ministries.
I can't help you out any further.
I need to get out of town.
Okay, it is never a good sign when a CEO has to end
an interview like that. "As I've said before,
our company has never done anything illegal.
Now have you seen a man in a blue fedora?
He's supposed to give me a new identity as I get pulled into
a helicopter that's already taking off.
Tell my daughter I loved her and my husband I didn't! I'm out!"
Now, I should say, other sharing ministries
have tried to distance themselves from Aliera,
claiming that "this sort of deception is not part
of legitimate, authentic healthcare sharing ministries."
And Aliera is definitely bad.
But one thing insurance commissioners
have repeatedly told us in researching this piece,
is how little transparency there is into
how these ministries operate, and just how wary they think
people should be of all of them.
And look, broadly, we have to do more in this country
to reduce the cost of healthcare.
Personally, I'd argue switching to a single-payer system
would remove a lot of these problems instantly,
but that clearly isn't happening anytime soon.
So in the meantime, I do get the appeal of lower-cost
health insurance. The problem is, this isn't that.
It's not insurance at all. And states need,
at the very least, to pass laws to make sure that people know
what they're getting into with HCSM'S, and to force them
to allocate funds properly. The problem is, some are going
in the opposite direction. Take Florida.
In 2018, after intense lobbying, it loosened
it's restrictions on HCSM'S even further,
going from requiring participants be
"members of the same religion," to merely requiring that
they "share a common set of ethical or religious beliefs."
And that could be basically anything.
At this point, the bar to entry is so low, just about anyone
can become an HCSM. And the reason I know that is,
this anyone did.
You may remember, back in 2015, we founded a church,
Our Lady of Perpetual Exemption, to demonstrate
that tax exemptions for churches enabled some of them
to do terrible things.
Well, just three months ago, we officially founded
a spinoff church called "Our Lady of Perpetual Health."
And we founded it, where else, but Florida.
I'm happy to tell you, that church now has its own
health care sharing ministry, "Johnnycare."
And the whole thing was scarily easy to do.
So, without further ado, please join me,
my most blessed congregants, at church.
- (ORGAN MUSIC PLAYING) -And you know,
I couldn't run an organization as important
as this ministry all by myself. So please welcome,
live from Johnnycare Headquarters
in sunny Florida, the Felicity Huffman
to my Willian H. Macy,
my dear wife and business partner, Wanda Jo.
Praise be to you, my Wanda.
Praise be to you, my John,
and praise be to Florida. That blessed state where
minimally regulated insurance knock-offs go to be born
and retired people go to die.
Amen to that.
I have heard the word of the lord, my John.
Oh, and what did it say, my Wanda?
It said "Thou must free thyself like a gazelle from the hand
of the hunter from the overreaching grasp
of government healthcare. Stick it to 'em."
Stick it to 'em!
Now Wanda, we're running the ministry as a church,
even though in Florida, we actually don't have to be.
Amen, praise Florida!
But we do need to fulfill the requirement that
our ministry provide for the financial
or medical needs of a participant through
contributions of other participants.
The good news is we have done that through our special
Johnnycare First Aid Kit, containing not one, not two,
but three Band-Aids.
It screams "the cheapest option we could find."
And you know what, my Wanda?
What, my John?
Now, why three Band-Aids? Because we know that in life,
sometimes accidents happen. But if they happen more
than three times, it just stops being our problem.
And let me be clear, when you sign up
for a membership, you're not paying for your own
first aid kit. You're paying for someone else's,
and they are paying for yours.
And that gives you freedom from insurance.
And us freedom from responsibility.
And beyond that, it's a very simple system.
If you need medical care, you go to the doctor,
you receive it, you request the bill,
and then you pay that bill on your own.
Leave us out of it. (LAUGHS)
Oh yeah, because if you submit that bill to us,
we're gonna reject it.
From his lips, to God's bigger lips in the sky.
Testify. Either because you engaged in the sin
of fornication beyond the bonds of matrimony...
You whoring little skeez.
Or you spent the day eating bon-bons on the couch
instead of going to the gym.
Or masturbated ever.
Whatever it is, we're going to reject it.
And it's as easy as that. No deductibles, no claims,
and no contracts, except for the one written on our hearts.
(ORGAN MUSIC PLAYING)
Now you can become a member of our Johnnycare ministry
for just $1.99 and we're limiting membership
to five thousand of you in Florida.
Not because we have to, but because that is the number
of first aid kits that we've bought.
So go to freedomfromhealthcare.org
and see if you qualify to send us money
and get almost nothing in return.
As close to nothing as we could get away with.
And to be clear, we should not be able
to get away with any of this.
Thank you to Wanda Jo, who, if history is any indication,
will disappear for three years and ultimately resurface
with a Canadian-Mohican son answering to Deb.
I just love you so much, my Wanda.
Oh! And I love you so much, my John.
Visit freedomfromhealthcare.org to learn how you
can stick it to 'em!
Stick it to 'em!
That's our show. Thank you so much for watching.