Almost a year after Solidarity HealthShare touted its commitment to transparency and pledged to improve member experience, the Catholic health sharing organization has not made public its annual finance audits, despite federal regulations requiring they be published.
Meanwhile, members and former members of the healthshare say they continue to suffer as a result of long-overdue medical bills left unpaid by Solidarity.
Some members have questioned whether financial instability at Solidarity has delayed bill payments and the release of public financial records.
And after reporting from the The Pillar last year, complaints against Solidarity have become so numerous that the Better Business Bureau has issued an alert for the health sharing ministry, noting a “pattern of complaints” alleging that Solidarity “is not reimbursing [members] for services they paid out of pocket for,” and that “they are being sent to collections and having to pay out of pocket due to the lack of response from the business.”
Solidarity told The Pillar this week that it “acknowledges that there have been times when some of our Members have experienced a delay in settling their healthcare expenses.”
But while some members say their bills have gone unpaid for longer than two years after they came due, Solidarity did not respond to questions about how long delays can be expected to last.
While Solidarity says it works with a third party to negotiate members’ medical bills, some members are concerned those negotiations can go on indefinitely without reaching an agreement, leaving families in limbo, and their credit at risk — and others say that delays have dragged on even after negotiations are finished and bills are approved for payment.
Solidarity is a health sharing ministry, an alternative to traditional health insurance in which members help pay each other’s medical expenses through a centralized administration, and is governed by a list of sharing guidelines. Members make a monthly payment similar to an insurance premium, and submit medical bills to the organization for payment through other members’ contributions.
Solidarity is an explicitly Catholic healthshare. Members are not required to be Catholic, but they must be Christians who agree with Catholic moral teaching. Abortion, contraception, sterilization and other medical procedures which violate Catholic teaching are not covered by the program.
Because they are not considered insurance, healthshares are exempt from many of the regulations governing insurance companies. There is no legal guarantee of payment in a healthcare sharing ministry, nor do they have to comply with solvency standards, prompt payment rules, or appeal rights.
But health sharing ministries are required by federal law to undergo annual audits, and to make the results of the audits publicly available.
In June 2022, amid outcry from Solidarity members over unpaid bills, The Pillar requested a copy of Solidarity’s recent audits. The ministry sent audits from 2019 and earlier, but did not send audits from 2020 or 2021.
A Solidarity spokesperson said last June that 2020 and 2021 audits had been delayed because of IRS changes in revenue recognition standards, but that a combined 2020-2021 audit would be available later that summer.
But nearly a year after the organization said its financial documents would be forthcoming, Solidarity still has not made the 2020-2021 audits available.
Solidarity told The Pillar on April 28 that audits have been completed but not yet been posted by the auditing firm. The organization did not say what firm had completed the audits, or when it expects they might be available to the public.
‘We want payment now’
While financial data goes unpublished, several current and former Solidarity members told The Pillar this month that they are still waiting on payment for bills that are now several years overdue, or that they saw bills paid only after they filed complaints with attorneys general — in both their own states and in Arizona, where Solidarity is based.
Some members say they wait years for their bills to be negotiated with healthcare providers, or approved for payment.
They’ve dealt with debt collectors and, in some cases, affected credit scores. Some members have been unable to return to see their doctors, due to unpaid balances on their account.
And even after they get approved, bills don’t always get paid, said Nick Sciarappa, who joined Solidarity in 2021, along with his wife Riley. Nick is a youth minister, and Riley is a realtor.
“It's overwhelming the amount of bills that have stacked up,” Nick told The Pillar
“We found what seemed like the most ethical and affordable healthshare service out there that matched our beliefs and had an unbeatable price tag associated with it, and that was Solidarity,” Nick told The Pillar.
At first, the process was confusing, but he had anticipated that a new system would come with a learning curve.
But it also required a level of documentation that he wasn’t prepared for.
“It was almost like a part-time job to monitor what bills were coming in, where they were coming in, what we were being charged from the hospitals compared to what they were telling us in their portals,” he said. “They don't do a stupendous job in updating you in regards to what's happening, what's coming from where, and that sort of thing.”
In the fall of 2021, Nick and Riley welcomed their first baby.
They had already met their “annual unshared amount” – similar to a deductible in an insurance plan – so Solidarity should have paid their bills in full.
The bills were quickly approved for payment, Nick said.
But they were never paid.
Eighteen months later, Nick and Riley still have more than $10,000 in outstanding bills from their baby’s delivery. The medical expenses were approved more than a year ago - but they’re still waiting for Solidarity to write a check.
“They say that they pay their bills in batches and that we've been approved, they are going to pay for them, it's in the batch, they're just waiting for a check to be generated,” Nick said.
Meanwhile, Nick said he and his wife have been harassed by collection agencies, and it’s difficult to sort out which agency is looking for which payment.
“Which collection agency did the blood test go to? Which collection agency did the hospital go to? Which collection agency did the checkup go to? Because they're all different, and they're all mounting and they all say, ‘We want payment now’.”
Most recently, he said, Solidarity has asked him if he can do a conference call with the hospital and a Solidarity employee, who could tell the hospital that Solidarity is planning to make the payment, but without any defined timeline.
But Nick said the wait time to speak with a hospital employee can sometimes be an hour, and wait times on Solidarity’s phone line are similar – so a conference call could take hours to set up, and would require employees from either Solidarity or the hospital to be willing to wait on hold for long amounts of time.
“I thought to myself, when will two working parents have the time to put these people together on a conference call?”
Nick said he’s considered making the payments himself, to make the collections calls go away, and then seeking reimbursement from Solidarity afterward. But he is not confident that Solidarity will pay him back in a timely manner – and if they didn’t, it would bankrupt him.
Nick and Riley left Solidarity at the beginning of this year.
Nick and his wife are expecting a second child. After their first baby was born, they waited to try to get pregnant again until after they left Solidarity.
“A part of our prayer and discernment for having a second kid using natural family planning was that we're not going to try to conceive until we get what we call ‘real insurance’,” Nick said.
“I don't want that to have to be a discerning factor. But of course it had to be for us.”
Nick and Riley have waited more than a year for Solidarity to pay medical bills that have already been approved for payment.
But other Solidarity members told The Pillar that their outstanding bills haven’t even made it that far – some say they’ve waited for years after a bill’s due date to seem bills even processed or negotiated, let alone approved for payment.
Solidarity says it saves members money by negotiating their medical bills for them. This is accomplished, Solidarity says, by using a third-party company - Advanced Medical Pricing Solutions (AMPS) - “to review and evaluate medical bills to help ensure that you are not charged beyond what is fair and just.”
In theory, negotiations like that can result in massive savings for Solidarity members.
But in practice, the negotiation process can drag on for years, members said. And if AMPS doesn’t reach an agreement with the healthcare provider, the bills are just left in limbo.
“It seems like this can go on indefinitely. They can basically choose to never settle for an amount,” said one former member, Jacqueline.
Jacqueline and her husband Mike still have more than $6,000 in unpaid medical bills from the birth of their son, who was born two-and-a-half years ago.
Mike said Solidarity initially failed to register their son in a computer system, and then accidentally created two accounts, both of which were mistakenly given an “active date” a year after their son’s birth – meaning that the bill from his delivery is not even eligible for processing and negotiation.
They have repeatedly asked Solidarity to resolve the error.
But with the bill now more than two years overdue, the hospital has told them it is no longer willing to negotiate with a third party. And Solidarity has not agreed to pay the amount the hospital is charging. So Mike and Jacqueline don’t know what they should do..
“I can have a certain amount of empathy for bumps that happen in the road, but the bumps that happen in the road should ultimately be the responsibility of the company who's creating the bumps,” Mike said.
“[But] right now, it seems like they're making problems, they're saying they're sorry, and it's the responsibility of these members to bear the burden of it. And frankly, I find that grossly inappropriate.”
Some people who spoke with The Pillar said their credit scores had been harmed by the overdue bills, despite Solidarity’s assurance that “providers cannot report disputed and delinquent bills to credit reporting agencies.”
Solidarity says that AMPS will work to restore credit scores for members if they do end up dropping because of an unpaid bill. But members said the process to fix their credit was also drawn out - and in the meantime, they were left in a financially precarious position.
Some people who spoke with The Pillar said they left Solidarity after months or years of waiting for bills to be paid, because they were tired of making monthly payments into a system that never seemed to reimburse them for health care expenses.
Erik, whose name has been changed for privacy reasons, said he even swtiched to a new job with a company-sponsored health insurance plan, just so he could get away from Solidarity. He was tired of dealing with the paperwork, the debt collectors, and at one point, even a court summons over an unpaid medical bill, he told The Pillar.
When that former member and his family left the healthshare in 2021, they still had unpaid bills. Today, he’s unsure about the status of those bills. One of them, he said, is more than two years old.
Erik hasn’t heard from any bill collectors in a while. He’s hoping that means maybe Solidarity has paid the bill.
But he’s not sure.
Solidarity has not informed Erik that they’ve paid the bill, or given them any update on its status.
And since he’s no longer a Solidarity member, he’s lost access to the member portal.
Erik and his wife recently had a new baby. They expect they will end up paying $8,000-10,000 with their current health insurance plan - far higher than the $2,500 family out-of-pocket max they had with Solidarity.
“But I am more at peace paying that than with all the heartache I had with Solidarity,” he said.
“I know that I'm not going to deal with Solidarity where I had a $2,500 family out of pocket, but I ended up paying thousands more than that, and with no assurance that I was going to get that money back.”
On April 28, a Solidarity spokesperson acknowledged to The Pillar that some members have experienced delays in healthcare payments.
“Unlike a traditional insurance company, Solidarity negotiates healthcare pricing directly with providers to ensure the delivery of high-quality, life-affirming healthcare at affordable rates to Members across the country,” the spokesperson said.
The Pillar asked Solidarity whether there is a cut-off time for negotiations with health care providers, and what happens if AMPS is unable to arrive at an agreement with a provider on a price for a service that has already been performed.
The Pillar also asked whether wait times of two or more years for payment of bills are reasonable within Solidarity's model.
Solidarity did not respond to those questions.
The company also declined to answer questions about its membership and staffing numbers.
Several former employees told The Pillar last year that the ministry was significantly understaffed and lacked a good data entry system, further contributing to delays in processing bills.
In its response to member complaints last year, Solidarity told The Pillar in June 2022, “Over the last 5 years, we have worked extremely hard to build a transparent and effective healthcare ministry that reflects our pro-life Catholic values.”
In its 2022 statement, Solidarity acknowledged that it “has experienced some challenges implementing policy and technological solutions to help our members effectively and efficiently share health expenses.”
But the organization said a new accreditation process would help it get up to speed.
“Solidarity is also beginning the process of being accredited by a third-party accrediting body that will evaluate Solidarity on issues of transparency, financial accountability, and member service,” it added. “Solidarity is confident that the steps it has implemented over the past few years are helping its members live out their values as they share their medical expenses with each other.”
The Pillar asked Solidarity this month about the status of its accreditation process. Solidarity did not respond.
Solidarity’s failure to explain its delay in payments - or offer an estimated timeline for addressing its backlog of unpaid bills - has left members and former members speculating about what might be going on inside the organization.
One member questioned whether the organization intentionally delays payment of large bills as a negotiation tactic - after several years of failing to receive payment, healthcare providers may be willing to accept amounts far lower than they otherwise would.
Another speculated that Solidarity might be failing to make payments because it is financially unstable. The person wondered whether Solidarity’s pricing model may be unsustainable, and questioned whether the ministry may be unwilling to share its audit data because it is not financially stable.
A family plan from Solidarity ranges from about $400-$550 per month, depending on the “annual unshared amount,” which is similar to a deductible.
In contrast, a mid-level family plan in the ACA insurance marketplace is more than $1,000 a month, and the average employer-sponsored health plan costs almost $2,000 a month.
Another member called Solidarity’s model “eerily similar to a Ponzi scheme, where you pay little bits of money out here and there, but primarily you collect from the victim.”
The Better Business Bureau has received so many complaints about Solidarity that it has issued an alert about the healthshare.
“BBB files indicate that this business has a pattern of complaints,” the alert says. “Specifically, consumer complaints allege that the business is not reimbursing them for services they paid out of pocket for. Consumers also state they are being sent to collections and having to pay out of pocket due to the lack of response from the business.”
The BBB said it submitted a written request to Solidarity in August 2022, asking them to respond to the complaints.
“On September 29th, 2022, the business responded to BBB's letter outlining the pattern of complaints with their plans to eliminate the pattern by prioritizing member education and instruction,” the alert continues.
“Solidarity states they are committed to the service of its members and continued improvement in member experience which largely falls on continued member education. BBB continues to closely monitor the complaints concerning this business and their effort to improve and reduce future customer complaints.”
A Better Business Bureau representative told The Pillar that Solidarity is continuing to communicate with the BBB about complaints, but declined to give details on the plan Solidarity had submitted about how it would work to eliminate the pattern of complaints.
Solidarity also declined to comment on the BBB’s alert, or about its plan to remedy the situation.
‘Healthcare should be affordable, ethical’
Despite the BBB warning and the complaints against Solidarity, the healthshare continues to be promoted in some Catholic circles.
Solidarity president and co-founder Chris Faddis is occasionally invited to speak on Catholic television and radio programs.
U.S. Senate candidate Eddie Garica, a Virginia Republican, praised Solidarity on Twitter this month for “working hard to expand affordable care options for all Americans.”
Garcia’s campaign did not respond to questions from The Pillar about Solidarity's compliance with accountability and transparency regulations.
The March for Life also promoted Solidarity on its Twitter account, saying in saying in January, “Our friends at @SolidarityHS have a commitment to ethical, affordable, life-affirming healthcare that has never been more important.”
The March for Life also declined to respond to questions from The Pillar.
The Catholic Medical Association, which has welcomed Solidarity as an exhibitor and sponsor at its annual conferences, defended its ties with the healthshare.
“CMA shares similar values with Solidarity - that healthcare should be affordable, ethical, and not violate conscience rights. Solidarity members want access to CMA physicians who share their values. Many individual CMA physician members have chosen to partner with Solidarity for their practice,” a spokesperson for the Catholic Medical Association told The Pillar.
“Solidarity fills a great need in the Church for those seeking authentically Catholic healthcare, and for those seeking to practice medicine according to their Faith and best medical evidence,” the spokesperson added.
The Catholic Medical Association declined to answer questions about whether it has concerns about Solidarity failing to pay members’ bills, or about the Better Business Bureau’s alerts.
The Catholic Diocese of Phoenix, where Solidarity is headquartered, told The Pillar that it has never formally recognized Solidarity as a Catholic organization, and declined further comment.
‘Bear false witness’
Members who have left Solidarity say they feel relieved but also disillusioned. Mainly, they say, they just want to have their outstanding bills paid and move on.
One former member, Angela, described her experience with Solidarity as being, in some ways, a microcosm of her experience with corruption in the broader institutional Church.
Angela was a Solidarity member when she suffered a miscarriage in 2019. She was out of town, visiting her husband’s family at the time, and had to visit an emergency room.
She had never had a miscarriage before, and Angela was devastated.
“I really didn't understand the emotional toll and impact that that would have,” Angela said.
The experience got worse, Angela said, when she had to keep contacting Solidarity — over and over again — for more than a year and a half to get her hospital bills paid.
“I was just exhausted,” Angela said.
“I was working, and I have small children, and Solidarity's wait times are so long. It's not like you can quickly make a phone call at work. It was a lot of work. And plus just keeping the paperwork and keeping the story straight because I can't rely on them to do it.”
Angela said employees did not seem to have personal emails or phone extensions, so she could never connect with the same person twice.
“At times it was a full-time job on administrative stuff, trying to get my money from them.”
Solidarity finally paid the emergency room bill, 19 months after Angela’s visit.
When Angela got pregnant again, the hospital where she was delivering decided that it would no longer work with Solidarity. So she had to pay for everything up front, and then get Solidarity to reimburse her.
“Which made me nervous because of what I knew about Solidarity paying people back,” she said. “I actually got a 0% interest rate card for a year, specifically because I was like, I don't have the money to pay. It's all cash. But hopefully I'll get my money back before this credit card rolls around and starts accruing interest.”
After the delivery, Angela forwarded her bill to Solidarity, but she never got a response.
She followed up repeatedly, but she never got an answer.
Finally, almost 11 months after her daughter was born, Angela filed a complaint with the Better Business Bureau, detailing Solidarity’s failures to respond to her.
“How quickly everything got paid and taken care of as soon as I made a formal complaint is shocking to me,” she told The Pillar. “It worked like a charm.”
Days after she filed a complaint, Angela got an email from Solidarity, saying that her bill was being processed. At the bottom of the email, an employee wrote a message: “Exodus 20:16.”
Scripture citations were not the norm on emails from Solidarity, Angela said, so she looked up the passage. It said, “Thou shalt not bear false witness against thy neighbor.”
“The response was shocking to me, just so rude and basically [they] called me a liar,” she said.
Angela left Solidarity a few months later.
“I have disentangled myself from that web, thank God,” she said.
“I made a bonfire. I literally made a bonfire and threw all my paperwork into the bonfire because I had such a huge stack of paper from them.”
Editor’s note: After the publication of this report, a Solidarity representative contacted The Pillar to state the organization’s position that: “Solidarity is not in violation of any federal law or regulation regarding health sharing ministries.” While Solidarity has not published a federally required audit for any year since 2019, the representative argued that “there is no timeline in the statute stating when the auditor must finish the audit.”
A spokesperson previously told The Pillar that a delay in publishing federally required audits “is understandable given the fact that health sharing ministries are a relatively new industry.” The Pillar notes that the first contemporary health sharing ministry in the U.S. was founded in 1981, more than 40 years ago.