FRANKFORT, Ky. (AP) - Don't try to tell Ken Walker that the health care program Medi-Share should be banned in Kentucky.
A freelance writer, Walker enrolled in the for-Christians-only initiative about 10 years ago. Since then, it has paid for cancer surgery for his wife and for a procedure to open clogged arteries around his heart.
"If it's a sham," Walker said, "how do you explain $90,000 in medical bills being taken care of?"
Franklin County Circuit Judge Thomas Wingate could rule within the next two weeks on whether Medi-Share can continue to operate in Kentucky. The Kentucky Department of Insurance has asked Wingate to ban the program because it is not subject to the same laws and regulations that govern conventional health insurance companies.
Medi-Share, which is supported by contributions from participating churchgoers, is based on the Biblical belief that Christians should take care of one another's needs. E. John Reinhold, head of the American Evangelical Association, said it is simply a cost-sharing program, not insurance.
Some former participants offer lesser than raving reviews, including Billie Young, a southern Baptist from Amory, Miss. Young said she dropped out of the program after three years because she found it extremely difficult to get her medical claims paid.
"They were good at turning me down," she said. "I feel that other people need to be warned."
An initiative of the American Evangelistic Association, the program excludes non-Christians because, organizers say, their lifestyles can result in unnecessary medical care. Participants can't smoke, use illegal drugs or abuse alcohol. They're also not allowed to enroll if they have pre-existing conditions like heart disease, diabetes or cancer.
Medi-Share, based in Melbourne, Fla., publishes a disclaimer that says it doesn't guarantee the payment of medical bills and that it should never be considered a substitute for an insurance policy. Even so, Reinhold said Medi-Share grew from $23 million in gross revenues in 2002 to $42.8 million in 2005, and now serves 19,000 families, including about 300 in Kentucky.
"When we found out about the Medi-Share program, it was our obligation to pursue this case to its conclusion," said Julie Mix McPeak, executive director of the Office of Insurance. "It is our duty to enforce the insurance code, and this product certainly appears to be insurance. The plan even mirrors many of the familiar aspects of an insurance policy from deductibles to copays to pre-existing condition exclusions. Call it what you want, it's insurance."
Rick Masters, an attorney for Medi-Share, disagrees. He said the organization isn't an insurer and should not be subject to the same regulations as insurance companies.
The Department of Insurance contends the judge should bar the cost-sharing program from Kentucky because people are paying monthly premiums for what they may believe to be insurance, yet they have no guarantee that their medical bills will be paid.
Reinhold said the cost-sharing ministry is careful not to use terms associated with the insurance industry in its publications so that people won't be confused. It also publishes a disclaimer to inform recipients that it is not an insurance plan.
The state Office of Insurance has warned in public statements that people involved in programs like Medi-Share can end up having to pay their own medical bills if the organizations fail to meet their financial obligations.
Kentucky, according to the Medi-Share Web site, is one of seven states that doesn't require such organizations to operate under the regulations that govern insurance companies. But the organizations are required to publish the disclaimer saying the medical plan "is not issued by an insurance company" and that "whether anyone chooses to pay your medical bills will be totally voluntary."
Young said she decided to try Medi-Share after seeing it advertised in a respected Christian magazine. She said she has since replaced it with a conventional health insurance plan.
"I wouldn't recommend it to anyone," Young said. "I wouldn't recommend it to my enemies."
But Walker, formerly of Louisville now living in Huntington, W.Va., said Medi-Share came through for him and his wife.
As a freelancer, Walker's income fluctuates depending on the number of writing assignments he lands. That's why he opted for the cheaper payments required by Medi-Share, typically less than $400 a month. Conventional insurance, Walker said, would have cost him some $800 a month more than Medi-Share.
Without Medi-Share, Walker said the medical bills for his wife's cancer and his heart procedure would have sunk his family.
"It was literally a lifeline," he said. "They proved themselves to me. Without Medi-Share, I would have been up the creek with no paddle."
© 2006 AP Wire and wire service sources. All Rights Reserved.
