Health Advice



Column: Trump promotes shoddy faith-based health plans in new attack on Obamacare

Michael Hiltzik, Los Angeles Times on

Published in Health & Fitness

Never let it be said that President Trump doesn't know how to take advantage of a crisis. For our latest example, let's look at how he has exploited the distractions caused by the COVID-19 pandemic to quietly launch yet another attack on the Affordable Care Act.

This attack involves promoting "healthcare sharing ministries," which are typically associated with religious faiths, to siphon enrollment from legitimate health insurance plans, thus weakening the latter in a way that is likely to drive up their costs.

A new regulation proposed by the Treasury Department would define healthcare sharing ministries as health insurance and for the first time allow some members to take a tax deduction for their monthly contributions.

That could encourage more people to sign up for what many healthcare experts consider substandard coverage.

The Trump administration's redefinition of sharing ministries as insurance contradicts the ministries' own self-description. They typically warn enrollees that they're not health insurance companies and don't guarantee that they'll pay any enrollee claims, even for ostensibly covered services.

Those formal disclaimers have enabled the ministries to avoid regulation by state insurance agencies. The plans are "largely unregulated," in the words of the Commonwealth Fund.


Thirty states exempt healthcare sharing ministries from insurance laws as long as they issue a written disclaimer that they're not insurance, and Congress granted them an exemption from Affordable Care Act rules.

The sharing ministries, however, are often marketed in ways that could confuse customers into believing they're buying real health insurance.

The Treasury Department slipped its proposed rule into the regulatory hopper on June 10, giving critics until Aug. 10 to file comments.

California Attorney Gen. Xavier Becerra and the attorneys general of 19 other states have weighed in. In their official comment, they say that "incentivizing payments to HSMs will only accelerate medical debt and poor health outcomes during an international health crisis" and give sharing plans greater incentive "to ramp up fraudulent marketing practices."


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