Solidarity HealthShare President and Co-Founder Chris Faddis joins The BS Show to discuss forthcoming changes in healthcare, including an end to automated insurance claim denials. Read the transcript or listen to the interview below!

Bob Sansevere (00:00):

We are joined by Christopher Faddis, co-founder and president of the nonprofit Healthcare Sharing Ministry Solidarity HealthShare, which is an ethical, affordable alternative to traditional health insurance and is faithful to the moral teachings of the Catholic Church. Chris, Donald Trump’s big, Beautiful Bill is Wow. I mean, it does a lot of things. And one of the things that the claim is, oh, it’s taking millions off of healthcare. No, it’s saying that able-bodied people need to work and it’s maybe taking them off of Medicaid. And also illegal immigrants shouldn’t be on Medicaid, and I don’t have a problem with that because you’re here illegally, and you know what? If you aren’t in any trouble, if you’re having any kind of health issues, the hospitals aren’t going to turn you away. But just I was in the media. I’m in the media. I worked for the Associated Press for a number of years back in the eighties, and I got to be honest with you, I’m embarrassed to say I worked there because they also skew things and it’s terrible what they do. And I’m just wondering from your standpoint, I mean, solidarity and the people that work for you, you’re straight shooters about what you do. Why can’t they get the word out properly of what’s happening?

Chris Faddis (01:18):

Yeah, this always happens whenever we expand any sort of government programs, whether you call them entitlement programs or welfare programs or the like, right? I mean,

(01:30):

There was expansions also for COVID, remember a lot of people that wouldn’t normally be on Medicaid were expanded to, and then there’s some of these other pieces. So yeah, whenever you pull that back, people say, wait a minute, you’re taking away everything. And the reality is we’re not taking away everything. I think the piece about able bodied people, I think most Americans agree with that, that if you can work, you should work. There should be some requirements there. Certainly, it does not appear that there’s any cuts to benefits for disabled people or elderly or the truly indigent populations. And I think that the idea here that, yeah, I mean this rapid expansion of illegal immigration that was promoted in the last administration is costing Americans a lot of money. And the reality is Medicaid should be for the people who paid into it all these years, and for those who are truly in need, like disabled persons in the indigent. So I think most people would agree with what’s really there. Unfortunately, the spin is so vast that all you have to do is say cuts and everyone just freaks out. They

Bob Sansevere (02:37):

Go nuts panics, and they misconstrue what it is. Now,

Chris Faddis (02:41):

I’m amazed. Interestingly, what I saw, Bob, is that hospitals are also freaking out about it, and I guess rightfully so because they’re the benefit of it, the beneficiary of this expansion, right? They’re guaranteed payment now on this population, whereas they might have to deal with more charity care and all those things, which by the way, nonprofit hospitals are supposed to do and really aren’t doing. So it is interesting that they’re the ones crying greatest. They’re the ones crying wolf pretty loudly, which makes you wonder who’s spinning the media on this? It might be these huge health systems.

Bob Sansevere (03:18):

Well, and there’s just so much going on. Also, as you well know, the Trump administration, they updated price transparency guidance for hospitals and payers. The problem is that this is nothing new, right? I mean, supposedly has had to been price transparency for years, but these hospitals don’t follow it. Will it be different now? Is there any repercussions if you don’t

Chris Faddis (03:43):

With the price transparency?

Bob Sansevere (03:44):

Yes.

Chris Faddis (03:45):

Yeah. Yeah, I think so. I mean, I think they’re strengthening the provisions, which will be good. We’ll see what happens if they actually start enforcing. I think hospitals will start to pay attention. Again, it looks like the Trump administration’s going to keep doing more on price transparency. So again, I think the more that continues, the more they’ll start to wake up that, Hey, this is here to stay for a bit. We might want to pay attention. The question will be, will they have big enough carrot or a big enough stick to get them to follow? And I think increasing the fines and actually raising compliance will be a big difference.

Bob Sansevere (04:21):

And here’s the other thing. I don’t think there’s a law, and you’re in Arizona, so you deal with this, and I don’t know if it’s like this in Minnesota, a new law in Arizona bans automated insurance claim denials. This is stunning that now the law requires physicians, not computers to review denied insurance claims starting a year from now, July of 2026. Why would this not be automatic? I mean, you were dealing with basically AI saying, ‘Nope, you’re not getting that insurance claim. You’re done. Forget it. Go away’. This is horrible.

Chris Faddis (04:52):

Yeah, yeah. And it is interesting because even before AI, I think most of these companies were not using physicians for most of these denials. I think certainly there’s probably a certain subset that required physician input, and then typically the second or third round of appeal is when they’d involve a physician on a denial. But I think the issue being that these, now that you’re using AI and you’re just using these arbitrary rules, it’s really not fair. And I would argue it doesn’t have to be a physician that you could really have a medically educated person, a nurse, or the like to review it. But in general, insurance companies are not using these claims, this pre-auth process or a claims denial process as a good thing. I mean, they’re not using it to help people. In our case, we do something called pre-notification, Bob, and you know how that works.

(05:46):

You’ve had to be through it. But in our case, we’re actually using this for a positive thing. For one, we’re making sure that we’re adhering to the ethical guidelines of what we do. But also another thing is a lot of times we might be able to offer suggestions to the member to say, Hey, you might want to look at this, or we would recommend a second opinion or whatever. And oftentimes that net’s a better result for the member that they’re happier with. So there’s a good way to do this and a bad way to do this. And I think unfortunately, some of these larger insurance players have really taken the path of lease payout and done this for the wrong reasons. And that’s led to some of these enforcement actions. And now I think this law within Arizona is probably going to become a model law around the country.

Bob Sansevere (06:29):

Well, good. I mean that it may be automated where I’m in Minnesota, I don’t know because I’ve never even heard of this before, that you’re automatically getting denied.

Chris Faddis (06:38):

Well, I think what came is a lot of this stuff coming out about United has really revealed what was happening. And unfortunately, United is being hailed as the real bad guy. But let’s be clear, Aetna, Blue Cross, Humana, they’re all doing the same thing. There’s really not a piece here where it’s just one bad guy out there. They’re all using the same tools.

Bob Sansevere (07:01):

You mean the United that’s based in Minnesota, that united, yes. That’s the one you’re

Chris Faddis (07:05):

Talking about. Right? Exactly. Exactly.

Bob Sansevere (07:07):

That’s a proud time for all of us here. Now, I got to ask you about this. You were mentioning about solidarity health share. The one thing that you do, and you help people with this, if I have something that’s serious and prices could be outrageous in one place, are you finding more and more of your people are actually going to another city or another state? Because the pricing is better and based on, because if I had something I knew was really big or important, I’m going to look and shop around. Are more of your people doing that and it’s a good

Chris Faddis (07:42):

Idea to look, we don’t see it as much. A lot of people talk about doing that for orthopedics and things. We don’t see that as much on those cases. People will travel a few hours, two or three hours, maybe. In most cases, we’re able to find a better deal within an hour of your home, so you don’t have to do that. When it comes to the more serious things though, like cancer, even cardiovascular care and some other things that are more chronic issues, I think a lot of people are more willing to travel. And a lot of that sometimes has to do with price, but it also sometimes has to do with access to the right kind of care. So we have people that will travel here to Arizona for a certain clinic that does cancer care and some other chronic diseases. We have a partnership nationwide with City of Hope Hospital. So there’s about four locations that people can choose from there. And sometimes I know of one couple that was traveling from Ohio to their hospital in Illinois, but then also had an oncologist in Ohio who was basically following the same protocol. So we have a mix of those things, and it really does help. It helps to keep the cost down. It helps to find the doctor you want. We’re seeing a lot more of that.

Bob Sansevere (08:55):

Well, and in a lot of cases, I mean, I happen to be in Minnesota where we have the Mayo Clinic in Minneapolis, in the Twin Cities, you have great doctors, some trained at the Mayo Clinic, but it’s sort of a place where great surgeons and doctors have come to. But there’s other states where you don’t find that, where you’re not going to find the kind of care you might get in a place like Minnesota, or I’m guessing Arizona’s got really good care too. So it’s different though in many of the other states. So it’s worth, it believes you to look.

Chris Faddis (09:26):

And then you have states, which, I mean, Arizona is one of these where you have, it’s, the whole system is really controlled by two or three big players. And so you have a lot less options, and then pricing becomes more difficult. So yeah, it really does give you that. The other benefit, Bob, that I find is really looking for smaller operations, really, I mean, honestly, these smaller surgical centers as well as orthopedic practices, even oncology practices. We have a great radiation oncologist here that we work with closely that is on his own. He’s independent from all the major systems. At one point, he was the head of radiology for Mayo, radiation oncology for Mayo, but he went on his own. And you know what I’m telling you, when you can find people like that, they’re diamonds to be able to find and work with, and you have a lot more control over your own care in those circumstances.

Bob Sansevere (10:21):

That’s great. And Chris, I wanted to remind people solidarityhealthshare.org, check it out. Great alternative to traditional healthcare and my family and I, we’ve been members for a number of years and it’s been a great experience for us. In the meantime, Chris Faddis will take a quick break. The BS Show will be right back.