By JoAnn Volk, Justin Giovannelli and Christina L. Goe

Health coverage products that don’t adhere to the Affordable Care Act’s (ACA) consumer protections continue to be marketed widely, often as a direct alternative to comprehensive coverage. This trend includes Health Care Sharing Ministries (HCSM), arrangements in which members, pledging to follow a common set of religious or ethical beliefs, make monthly contributions to help pay the qualifying medical expenses of other members. While viewed as an alternative to marketplace plans, they don’t follow the same rules and typically don’t provide any of the same protections. Despite indications of growing or significant enrollment in HCSMs in some states, there is a dearth of data on their operations and finances. Now a Massachusetts rule governing HCSMs has offered a glimpse behind the curtain.

In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s JoAnn Volk and Justin Giovannelli along with Christina Goe dig into data on HCSMs operating in Massachusetts, thanks to a state requirement to regularly report on enrollment, membership fees, and other information about HCSM operations and finances. The data show that only about half of all claims submitted by members were deemed eligible for payment, and members saw as little as 16 percent of their monthly contributions paid out in claims. You can read more about Massachusetts’s reporting requirement and the information it has uncovered here.