- The main story is about the issues with healthcare in America, particularly the link between health insurance and employment.
- Health care sharing ministries (HCSMs) are introduced as an alternative to health insurance.
- HCSMs are non-profit organizations where people with similar religious beliefs agree to help cover each other's medical bills.
- The popularity of HCSMs has grown rapidly, with over a million members today.
- While HCSMs may appear similar to insurance, they are not regulated like insurance companies and can place restrictions on coverage.
- HCSMs may not cover pre-existing conditions, essential services under the Affordable Care Act, or certain lifestyle-related illnesses.
- Some HCSMs can deny coverage based on morality, such as smoking or being in a same-sex relationship.
- There is no guarantee that bills will be paid by HCSMs, as they are voluntary associations.

- The video discusses the issues and concerns surrounding healthcare sharing ministries (HCSMs) like Liberty HealthShare and Alira.
- Liberty HealthShare claims to have a successful history of sharing medical bills, but their process is unreliable and payments can be slow or non-existent.
- The Better Business Bureau has received over 500 complaints about Liberty HealthShare in the past three years.
- Alira, an administrator for HCSMs, has been involved in denying coverage and using morality clauses to reject claims.
- Traditional insurance companies have horror stories too, but HCSMs lack financial accountability and transparency.
- Florida has loosened its restrictions on HCSMs, making it easier for anyone to start their own ministry.
- The video concludes that more regulation and transparency is needed for HCSMs to protect consumers.

- The speaker is promoting a ministry that claims to provide financial and medical needs without government healthcare.
- The ministry offers a Johnny Care First Aid Kit with 3 Band-Aids as the cheapest option.
- The system works by participants paying for each other's first aid kits, providing freedom from insurance and responsibility.
- If medical care is needed, participants must pay the bill themselves and not involve the ministry.
- The ministry will reject any bills submitted to them for various reasons, including engaging in sin or not taking care of one's health.
- Membership to the ministry is limited to 5,000 people in Florida, based on the number of first aid kits available.
- The speaker encourages people to visit freedomfromhealthcare.org to learn more and support the ministry.

- The text discusses the issues with healthcare in America, particularly the connection between health insurance and employment.
- Health care sharing ministries (HCSMs) are introduced as an alternative to health insurance, where people with similar religious beliefs agree to help cover each other's medical bills.
- HCSMs have grown in popularity, but they are not regulated like insurance companies and may have restrictions on coverage.
- HCSMs may not cover pre-existing conditions, essential services under the Affordable Care Act, or certain lifestyle-related illnesses.
- Some HCSMs can deny coverage based on morality, such as smoking or being in a same-sex relationship.
- HCSMs are voluntary associations and there is no guarantee that bills will be paid.
- The video discusses concerns with specific HCSMs like Liberty HealthShare and Alira, highlighting issues with unreliable processes, slow payments, and denial of coverage.
- Florida has made it easier for anyone to start their own HCSM.
- The video concludes that more regulation and transparency is needed for HCSMs to protect consumers.
- The speaker promotes a ministry that offers financial and medical assistance without government healthcare, with options like a Johnny Care First Aid Kit.
- Participants pay for each other's first aid kits, but if medical care is needed, they must pay the bill themselves and not involve the ministry.
- The ministry can reject submitted bills for various reasons, including engaging in sin or not taking care of one's health.
- Membership to the ministry is limited to 5,000 people in Florida.
- The speaker encourages people to visit freedomfromhealthcare.org to learn more and support the ministry.

Health Care Sharing Ministries, or HCSMs, advertise themselves as a more affordable, faith-based alternative to health insurance. But John Oliver explains some of the massive limitations these plans can have.

Connect with Last Week Tonight online... 

Subscribe to the Last Week Tonight YouTube channel for more almost news as it almost happens: www.youtube.com/lastweektonight 

Find Last Week Tonight on Facebook like your mom would: www.facebook.com/lastweektonight 

Follow us on Twitter for news about jokes and jokes about news: www.twitter.com/lastweektonight 

Visit our official site for all that other stuff at once: www.hbo.com/lastweektonight

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 a plastic turtle, a fork, 6 magic markers, and a cat's toy bell, which, credit where it's due, is the most promising advancement in cat hiding places since Under the Dresser.

Access to healthcare is a big problem in America.

And 1 of the key reasons is that health insurance is often linked to employment.

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 7.6 million jobs 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.

At Liberty HealthShare, we support each other and keep health costs down.

We're changing the way you're paying for health care.

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 1 weird older man very much on his own in black and white.

He's in a slightly different thing, and we're not gonna 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 1 and not even realized it, because they have 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, is that they are also not health insurance.

Generally, they are non-profits where people who share religious beliefs, usually Christianity, agree to help cover each other's medical bills.

Here is a heartwarming story about what 1 of them looks like in practice.

We're praying for a young lady named Kimberly.

Bob Stedman and his family are praying for someone they've never met.

They've also prepared a card with a check for $561.

Bear her burden by sending them some money.

A scene like this plays out here once a month.

It does take a measure of faith to do it.

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 Deborah Messing retweets your GoFundMe.

That's great, Deborah, but did you donate?

And it does feel more personal sending $500 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.

Can you imagine being that person and getting the check in

You know, not knowing that someone was gonna help you and then suddenly you have all this help.

Faith that it's gonna get paid, faith in God, and it's just amazing.

Faith, strangers, coming together, throwing 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 1 local news thirst trap.

And HCSMs are definitely an alternative, but, as you've probably guessed because you're learning about them on this show, and 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 healthcare 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, 1 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 1.

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 want to stick it to him, 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, beaten 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, a predecessor of it, had to have been in continuous existence since 1999.

But unfortunately, that predecessor detail left room for exploitation because new ministries simply started affiliating themselves with previously existing churches.

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 has been in existence and continually sharing since the 1600s, 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.

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 HESMs will insist that they make it abundantly clear that they are not health insurance.

Many do seem to go out of their way to make themselves appear as insurance-like as possible.

For start, they're sometimes sold through insurance brokers, alongside actual insurance plans.

And while the Obamacare marketplace offers plans in 4 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 is 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 Emeralds, because you could literally never.

But while these HCSMs may have the optics of insurance, there are some very important differences.

For start, they don't have to abide by laws governing insurance products.

Meaning, there is 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.

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 1 of the biggest excuses HGSMs can use to deny coverage, and that is morality.

Because that means that 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.

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.

Rub your penis or vagina on someone else's vagina or penis, respectively.

Liberties 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 Samaritans' attention.

But sweeping moral judgment isn't the only leeway that these organizations have.

Because they are 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.

Figuratively, of course, because literally, it's not a contract.

And as for his claim there that Liberty successfully shared 100 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 is 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 as uninsured, 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 have 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 1 with the heart contract, have found payments can be slow to non-existent.

In the past 3 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, 1 claiming 90,000 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.

And while Liberty claims that 2019 was a particularly difficult year, and 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 Alira, which has been heavily involved with a number of health-sharing ministries over the years.

First, 1 called Unity, then 1 called Trinity, which now goes by Shareity.

Although, those names sound less like health-care organizations and more like characters in a religious-themed Captain Planet knockoff.

When their powers combine, they get canceled after 2 episodes.

Alira presents itself as merely an administrator for HCSMs, but it is intricately connected to the ones that it works with, and very much by design.

Just 6 weeks after Trinity was incorporated, it signed a deal with Alira, stipulating that Alira would have exclusive ownership rights to the membership roster, and was the sole party developing and marketing the plans, including the HCSM components.

So, Alira'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 Alira and its ministries have been ruthless in denying coverage, wielding morality clauses hard.

When 1 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.

Alira 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 a lira.

Ten-year-old Lola Grace Seegers is healthy, just 4 months after brain surgery.

On September 11th she was rushed from the local ER in Greene County by ambulance to Children's Healthier Scottish Rite where doctors removed a softball-sized brain tumor.

But last week came the bill from their health plan, Alera Companies.

Alera says Children's is out of network and won't pay the $325,000 bill.

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, Alira 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 that you can get onto 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 that 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 80 percent for care, There is no such requirement for HCSMs.

And you can probably tell where this is going.

Because investigations have found that out of every hundred dollars a Trinity member paid in premiums, only 16 dollars went towards paying medical expenses, with the rest being kicked up to Alira.

And paying out 16 percent of the money that 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 percent makes you think, Is 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 Alira to ask her about its reluctance to pay out claims, her response was not particularly reassuring.

have any apologies to the members who believe their claims ought to be played and they're not paid.

We're not a health care sharing ministry, Mr.

We only administer on behalf of the ministries.

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.

Now, I should say, other sharing ministries have tried to distance themselves from Alira, claiming that this sort of deception is not part of legitimate, authentic, healthcare sharing ministries.

But 1 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 health care.

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.

And states need, at the very least, to pass laws to make sure that people know what they're getting into with HCSMs and to force them to allocate funds properly.

The problem is, some are going in the opposite direction.

In 2018, after intense lobbying, it loosened its restrictions on HCSMs even further, going from requiring that participants be members of the same religion to merely requiring that they...

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 might 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 3 months ago, we officially founded a spin-off church called Our Lady of Perpetual Health.

And we founded it, where else but Florida.

And I'm happy to tell you that church now has its own healthcare-sharing ministry, Johnny Care.

And the whole thing was scarily easy to do.

So, without further ado, please join me, my most blessed congregants, at church.

And you know, I couldn't run an organization as important as this ministry all by myself, so please welcome, live from Johnny Care headquarters in sunny Florida, the Felicity Huffman to my William H.

Macy, my dear wife and business partner, Wanda Jo.

Praise be to you, my John, and praise be to Florida, that blessed state where minimally regulated insurance knockoffs go to be bored and retired people go to die.

I have heard the word of the Lord, Mahjong.

It said, thou must free thyself like a gazelle from the hand of the hunter, from the overreaching grasp of government health care.

Now, Wanda, we're running the ministry as a church, even though in Florida, we actually don't have to be.

But we do need to fulfill the requirement that our ministry provide for the financial or medical needs of a participant through contributions from other participants.

And the good news is, we have done that through our special Johnny Care First Aid Kit containing not 1, Not 2, but 3 Band-Aids.

It screams the cheapest option that we could find.

Because we know that in life, sometimes accidents happen.

But if they happen more than 3 times, it just stops being our problem.

And let me be clear, when you sign up for 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 beyond that, it's a very simple system.

If you need medical care, you go to the doctor, you receive it, you request a bill, and then you pay that bill on your own.

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.

Either because you engaged in the sin of fornication beyond the bonds of matrimony...

...Or you spent the day eating bonbons on the couch instead of going to the gym.

Whatever it is, we're going to reject it, and it's as easy as that.

No claims and no contracts, except for the 1 written on our hearts.

♪ ♪ Now, you can become a member of our Johnny Care Ministry for just $1.99, and we're limiting membership to 5,000 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 3 years and ultimately resurface in a Canadian Mohegan Sun, answering to Deb.

Visit freedomfromhealthcare.org to learn how you can stick it to them.

See all LastWeekTonight transcripts on Youtube

Health Care Sharing Ministries: Last Week Tonight with John Oliver (HBO)