Christians tired of dealing with insurance companies and unwilling to pay fines for opting out of the health insurance mandate of the Affordable Care Act found a ready option in health care cost-sharing ministries.
The ministries have been around for decades but their popularity bloomed after President Barack Obama signed the ACA into law in 2010. The ACA required people to acquire health insurance — the “individual mandate” — or face a fine.
The ACA also had an exemption for health care cost-sharing ministries, which are not technically health insurance but provide group sharing of medical bills among members. The ministries had fewer than 200,000 members nationwide before the ACA was enacted. Participation rose to about 1 million after. Dave Weldon, president of the Alliance of Health Care Sharing Ministries, said there now are as many as 1.5 million members of the more than 100 shared ministries.
Most of the ministries are small, congregation-based groups of members of the Mennonite or Old German Baptist Brethren faiths with closed memberships, according to the alliance.
Three major health care cost-sharing ministries with national coverage and open memberships are Christian Healthcare Ministries of Barberton, Ohio; Christian Care Ministries’ Medi-Share of Melbourne, Florida; and Samaritan Ministries of Peoria, Illinois.
The premise of the ministries is that members contribute monthly fees that are then used for other members’ medical bills. The major players have differences: Samaritan has its members send payments directly to other members with legitimate bills, while Medi-Share pays out of a more traditional central fund.
Christian Care, with 400,000 members, and Samaritan, with 270,000, were the drivers in the 2007 formation of the alliance, which is also based in Melbourne, Florida. Christian Healthcare joined the lobbying group in 2017; a spokesman said its membership totaled several hundred thousand.
Weldon said the growth of the ministries was a result of rising health insurance costs and frustration with health insurance companies, which operate on a profit basis. The nonprofit health care cost-sharing ministries provided sanctuary and a sense of community among members.
“Their obligation is to their members and to Scripture,” said Weldon, a former seven-term U.S. representative from Florida and a physician.
The fine associated with the individual mandate of the Affordable Care Act has been eliminated, removing one of the motivations people had for joining a health care cost-sharing ministry. The rapid growth of the ministries has slowed but has continued, Weldon said.
No Earthly Guarantee
Health care cost-sharing ministries’ open membership isn’t exactly open. Potential participants have to be practicing Christians attending church regularly and refrain from abuse of alcohol or the use of tobacco and illegal drugs.
Samaritan, on its website, said a “rare celebratory cigar” is allowed for events such as the birth of a child. Christian Healthcare, for example, also details health services that it does not cover, such as unwed mothers giving birth, abortions, weight loss programs, surgeries and self-inflicted injuries.
Those restrictions weren’t a concern for Gary Thomas of Fort Smith, who joined Christian Healthcare Ministries in 1992. Thomas, now 61, was married with four children and ministering at a church in Camden when he took the leap of faith.
Health care bills were becoming a strain when he heard Christian financial adviser Larry Burkett on the radio extolling the virtues of the ministries. Thomas and his wife prayed over the decision before signing up.
Thomas, a minister and cartoonist for Arkansas Baptist News, joined to save money and fulfill his calling, he said, since Obamacare was almost two decades away.
“I was backed into a corner as far as health insurance for my family,” Thomas said. “The basic premise was believers in the body of Christ should be helping other believers in the body of Christ with their needs and one of those needs is health care.”
Because there is no contract between the member and the ministries — each website of the three national ministries clearly states it is not health insurance — the ministries aren’t legally liable for the medical bills. And because the groups are not health insurance providers under the law, complaints have to be reported to the member’s state attorney general office; Arkansas law exempts health care cost-sharing ministries from state insurance oversight.
The Arkansas Insurance Department said it refers any complaints about the cost-sharing ministries to the attorney general’s office. A spokeswoman for the attorney general said the office hasn’t received any complaints about health care cost-sharing ministries.
“A common question [we were asked] was, what if the other people in your network decide not to help you?” Thomas said. “To me, it’s not a matter of trusting them; it’s trusting God. Being a believer, I trust him with my eternity. If you can trust him with your eternity, you can trust him with your health care.”
How They Work
Each of the three major sharing ministries offer varying services and fees. Christian Healthcare offers three levels of membership that range from $150 monthly per person with 100% coverage after a $500 deductible at the gold level to $45 monthly per person with 100% coverage after a $5,000 deductible.
Christian Healthcare said it has paid out $3.5 billion in benefits since 1981. Medi-Share has paid out $2 billion since 1993 and Samaritan $1.8 billion since 1994.
The ministries also have prayer requests, and cards go back and forth between participants. Thomas said when his family received a box of prayer letters after a medical need, it was a great encouragement.
“That they know their financial gifts are going to help fellow Christians just as their fellow Christians’ financial gifts will help them, if the need arises [is a big selling point],” said Christian Healthcare spokesman David Loughney. “The biblical basis is a key driver.”
Ryan James with the Arkansas Insurance Department said a health care ministry that didn’t clearly state it wasn’t insurance could face a criminal investigation. Three states have issued cease and desist orders against a for-profit ministry, Aliera, but Weldon said members of the alliance work hard to avoid non-payment problems.
“We try not to compare ourselves to insurance because we are not insurance, but the savings for many people in a sharing ministry versus insurance can amount to thousands of dollars a year,” Weldon said. “They’re all different. They’re all operate differently, they are all priced differently, what they allow and what they don’t allow vary. People need to do their homework if they are considering a sharing ministry.”
Sample Plan Rates
| CHRISTIAN HEALTHCARE MINISTRIES | ||
| Level | Monthly Fee* | Deductible |
| Gold | $150 | $500 |
| Silver | $85 | $1,000 |
| Bronze | $45 | $5,000 |
| MEDI-SHARE | ||
| Level | Monthly Fee† | Deductible |
| Least Expensive | $293 | $10,500 |
| Most Expensive | $1,004 | $1,750 |
| SAMARITAN MINISTRIES | ||
| Level | Monthly Fee† | Deductible |
| Classic | $530 | $300 |
| Basic | $300 | $1,500 |
