Bill Description: House Bill 146 adds new regulations and prohibitions with which a health care sharing ministry must abide in order to be recognized as not being a form of insurance.
Does it give government any new, additional, or expanded power to prohibit, restrict, or regulate activities in the free market? Conversely, does it eliminate or reduce government intervention in the market?
Section 41-121, Idaho Code, exempts health care sharing ministries from regulation under the insurance code. This section of code was added in 2013 in response to the passage of the federal Affordable Care Act. House Bill 146 modifies Idaho code to add several new requirements for a health care sharing ministry seeking to qualify for this exemption.
Among these additions are requirements that the ministry "reimburses patrons for medical expenses or sharing requests submitted" or "seeks member assistance in paying medical expenses or sharing requests."
Additionally, a qualifying health care sharing ministry is subject to a new list of eight prohibitions, including some common business practices such as paying "commission or remuneration for marketing or enrollment" and conditioning assistance "upon the use of specified health care providers."
A qualifying health care sharing ministry is forbidden to engage in several other practices. These include: "reject individuals from participation based solely on individual health risk"; "discontinue membership or eligibility to receive sharing payments based solely on the development of a medical condition or request for assistance"; "assume risk or indicate that it is assuming risk"; "unfairly discriminate on the basis of race, sex, national origin, or disability"; "collect consideration in promise of future financial security or future claims"; and "describe its services in a manner that could cause a likelihood of confusion or of misunderstanding as to the services offered by the health care sharing ministry."
House Bill 146 newly subjects health care sharing ministries to sections 41-1301 through 41-1327, Idaho Code, regarding trade practices and frauds, to the extent applicable.
Does it increase barriers to entry into the market? Examples include occupational licensure, the minimum wage, and restrictions on home businesses. Conversely, does it remove barriers to entry into the market?
Section 41-121, Idaho Code, exempts health care sharing ministries from regulation under the insurance code. House Bill 146 modifies this code to add several new requirements for a health care sharing ministry seeking to qualify for this exemption. Existing code requires that a health care sharing ministry be a "faith-based nonprofit organization that is tax exempt under the Internal Revenue Code."
House Bill 146 modifies Section 41-121, Idaho Code, to require that a qualifying health care sharing ministry be "owned or operated by a religious organization recognized by the internal revenue service as tax exempt" and have "been in existence, or a predecessor of which has been in existence, at all times since December 31, 1999, and medical expenses of its members have been shared continuously and without interruption since at least December 31, 1999."
Requiring that an entity be preexisting in order to qualify for an exemption critical to its existence is the ultimate barrier to entry.