Renteria v. New Mexico Office of the Superintendent

CourtCourt of Appeals for the Tenth Circuit
DecidedFebruary 27, 2025
Docket23-2123
StatusUnpublished

This text of Renteria v. New Mexico Office of the Superintendent (Renteria v. New Mexico Office of the Superintendent) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Renteria v. New Mexico Office of the Superintendent, (10th Cir. 2025).

Opinion

Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 1 FILED United States Court of Appeals Tenth Circuit UNITED STATES COURT OF APPEALS February 27, 2025 FOR THE TENTH CIRCUIT _________________________________ Christopher M. Wolpert Clerk of Court BREANNA RENTERIA; LAURA SMITH; TAMMY WATERS,

Plaintiffs - Appellants,

v. No. 23-2123 (D.C. No. 1:23-CV-00276-MLG-KK) NEW MEXICO OFFICE OF THE (D. N.M.) SUPERINTENDENT OF INSURANCE; ALICE T. KANE, Superintendent of Insurance, in her official capacity,

Defendants - Appellees,

and

GOSPEL LIGHT MENNONITE CHURCH MEDICAL AID PLAN, d/b/a Liberty HealthShare,

Plaintiff. _________________________________

ORDER AND JUDGMENT* _________________________________

Before CARSON, ROSSMAN, and FEDERICO, Circuit Judges. _________________________________

* This order and judgment is not binding precedent, except under the

doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Federal Rule of Appellate Procedure 32.1 and 10th Circuit Rule 32.1. Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 2

This appeal arises from an enforcement action taken by the New

Mexico Office of the Superintendent of Insurance (OSI) against Gospel

Light Mennonite Church Medical Aid Plan (d/b/a Liberty HealthShare)

(Gospel Light), which resulted in a final order that required Gospel Light

to cease operating as a health care sharing ministry (HCSM) in New Mexico.

Plaintiffs are Breanna Renteria, Laura Smith, and Tammy Waters

(Plaintiffs), three members of Gospel Light.1 Defendants are OSI and Alice

T. Kane, the Superintendent of Insurance, in her official capacity. Plaintiffs

sought a preliminary injunction to enjoin OSI from enforcing the final order,

which the district court denied. Exercising jurisdiction under 28 U.S.C.

§ 1292(a)(1), we affirm the denial of the preliminary injunction.

I

A

The Internal Revenue Code (IRC) defines HCSMs as tax-exempt

§ 501(c)(3) organizations, “members of which share a common set of ethical

or religious beliefs and share medical expenses among members in

1 As detailed more fully below, the district court abstained from hearing all claims raised by Gospel Light, the corporate entity, based upon the Younger abstention doctrine and dismissed these claims with prejudice. See Aplt. App. V at 100. Although Gospel Light appealed that order generally, it did not specifically appeal the dismissal so that decision is not before us in this appeal. Nevertheless, for simplicity’s sake, we will refer to the individual Plaintiffs interchangeably with Gospel Light.

2 Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 3

accordance with those beliefs.” 26 U.S.C. § 5000A(d)(2)(B)(ii)(I)–(II). An

HCSM must share expenses “without regard to the State in which a member

resides or is employed,” must allow members to “retain membership even

after they develop a medical condition,” and must have existed and shared

expenses “continuously and without interruption since at least December

31, 1999.” Id. § 5000A(d)(2)(B)(ii)(II)–(IV).

In recent years, OSI issued statements warning the public about

HCSMs operating in New Mexico. In a press release dated December 3,

2019, OSI stated:

A few health care sharing ministries (also known as health care sharing organizations) operate in New Mexico. These organizations do not offer insurance, but may present plans in a way that look and feel similar to a health insurance plan. Members of these organizations “share” health costs on a voluntary basis. Consumers should be aware that these plans have no obligation to pay for any medical services and have no requirement to cover any particular categories of health care services, such as preventive care.

Aplt. App. I at 129–30. On March 26, 2020, OSI issued another press release

that described HCSMs as “an unauthorized insurance product that likely

will not provide the protections of an authorized, regulated, and [Affordable

Care Act (ACA)] compliant major medical plan”; listed examples of potential

gaps in coverage a consumer could face; and urged consumers to purchase

3 Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 4

“an ACA compliant plan.” Id. at 131. Finally, OSI issued a “Consumer

Advisory” in March of 20212 that stated:

As the Special Enrollment Period gets underway, OSI wants consumers to know that there are scammers trying to lure people into purchasing low-quality health insurance or health insurance-like products. These low-quality products DO NOT meet the requirements of the ACA because they offer extremely limited coverage. These might be short-term plans, trade association plans, health care sharing ministries or other limited plans. These bad plans can leave consumers stuck with huge medical bills from doctors and hospitals. These non-ACA plans deny and limit health care coverage by:

✓ Limiting coverage for pre-existing conditions ✓ Limiting prescription coverage ✓ Limiting coverage for hospitalizations and emergency rooms ✓ Limited or no coverage for mental health / behavioral health treatment ✓ Limiting coverage for outpatient / same-day surgery

Id. at 200.

B

Gospel Light’s members make monthly voluntary gifts to assist other

members with medical expenses but nonetheless maintain ultimate

responsibility for their own medical bills. Members must live by Christian

standards and may not request sharing for certain medical expenses, for

2The consumer advisory itself does not display a year. Plaintiffs asserted in their motion for a preliminary injunction that OSI issued the consumer advisory in 2021.

4 Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 5

example, contraceptives, abortion, gender affirming care, or alcohol or drug

rehabilitation.

On July 1, 2020, OSI received a consumer complaint in which a Gospel

Light member asserted that the HCSM was “continuing to take money and

not give [the consumer his] reimbursement.” Aplt. App. II at 56. On May

12, 2021, OSI received another consumer complaint in which a different

member asserted that despite paying her premiums on time, Gospel Light

canceled a payment for a hospital bill after sending it to the wrong address

and subsequently put the consumer “back on the 6 month wait.” Id. at 59.

After investigating these complaints, OSI initiated an administrative

enforcement action. It also ordered Gospel Light “to cease and desist from

transacting insurance business in New Mexico,” to provide OSI with data

on Gospel Light’s plans sold in New Mexico, and to show cause why OSI

should not fine Gospel Light for each unauthorized insurance transaction.

Id. at 43.

Gospel Light requested a hearing, and an OSI hearing officer found

that Gospel Light “pa[id], indemnif[ied], or guarantee[d] [its] members as

to loss from certain specified contingencies, perils, or risks,” and as such,

met the New Mexico definition of insurance. Id. at 123. The hearing officer

also found that Gospel Light sold benefit plans or insurance without a

certificate of authority issued by OSI. Based on these conclusions, the

5 Appellate Case: 23-2123 Document: 88-1 Date Filed: 02/27/2025 Page: 6

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