Judge rules against Ga. faith-based health firm
A state district court judge in Texas on Friday blocked a Georgia company running a faith-based health ministry from enrolling any new members in the state at this time.
The decision by Judge Lora Livingston in Travis County came as scrutiny of Atlanta-based Aliera Healthcare continues to heat up across the nation. The company is accused in multiple states, including in Texas, of illegally selling insurance and misleading customers into believing they were buying full coverage health plans through a Christian health care cost-sharing ministry that often turned out to be worthless.
Late Thursday afternoon, the Texas Attorney General’s Office filed a motion as part of its ongoing lawsuit. The motion sought not only to stop the company from enrolling new members but also to preserve and protect any member dues paid by Texans as the case proceeds.
Livingston, though, granted only the first part of the state’s request, ruling Aliera “is prohibited from accepting any new customers in the State of Texas until such time that this case is resolved.” She found enough evidence that the temporary restraining order was needed to prevent “irreparable injury, loss and/or damage.” The second part of the state’s request could be addressed at a follow-up hearing July 29.
“Despite being given less than 24 hours notice of this hearing, and without an opportunity to present testimony, we are pleased that we will continue serving our customers in Texas under this order,” Aliera said in a statement.
Aliera currently has 17,000 members in Texas and 100,000 across the nation.
Aliera Healthcare, formed in late 2015 as a for-profit company, has now changed its name to Aliera Companies. It maintained at the hearing and in other court filings it is not and has never claimed to be a health insurance company and acts only as the administrator for
an affiliated but separate healthshare ministry called Trinty Healthshare.
The state has argued that there is no daylight between the two and that Aliera is trying to piggyback on “Trinity’s non-profit status to sell health care plans purporting to be sharing ministry plans but Aliera would keep complete control of the money and the administration of the plans,” according to the request for the restraining order.
Health care cost-sharing ministries are small but growing slice of health coverage in this country where members of a faith community pay into a fund to be used for future medical bills. But because they are not insurance, healthsharing ministries are exempt from most laws and regulations overseeing insurance. There is also no legal obligation to pay claims.
Scores of Aliera customers have complained to authorities across the country that they believed they were buying insurance — or something close to it — but then, after paying thousands of dollars to the fund, their claims were denied, often for having a pre-existing condition or some other disqualifying reason. Regulated insurance under the Affordable Care Act cannot deny claims based on pre-existing conditions.
In June, Attorney General Ken Paxton sued Aliera and asked for damages of $10,000 per violation and $10,000 for each day of violation. In the petition filed Thursday, the state argued that “merely stating that a business is not insurance will not suffice to take the business out of the realm of insurance regulation.”
In Georgia, 10 consumer complaints against Aliera have been forwarded to the federal authorities, the Georgia Attorney General’s office confirmed this week. A Houston-area woman, who filed one of the complaints, said Georgia officials told her that the complaints were sent to the FBI.
In addition, Washington’s insurance commissioner ordered the company to stop doing business in its state, and insurance officials in Massachusetts and New Hampshire have posted warnings about the company on their websites.
Aliera is expected to file a response in the Texas case next week. In a previous statement to the Chronicle, it said it would “vigorously defend against the false claims directed at our company.”
A history of the accusations against the company and the troubled past of one of its founders were detailed in a Houston Chronicle story July 7.