The Affordable Care Act (ACA) has people and health insurance companies worried that their healthcare costs will go up. Historically, health insurance companies have been able to screen out those with pre-existing conditions or drop others who are costing them too much. With the ACA in place, they won’t be able to do that, so those paying for health insurance may pay more to cover sicker people who are now covered.
This mindset about sharing healthcare costs grates against some but is wholeheartedly accepted by others. An alternative to purchasing individual health insurance, if you aren’t already covered through work, Medicare, the Indian Health Service or several other government programs, may be a “health care sharing ministry”. These are not health insurance plans. They operate more like co-ops and are based on the Christian philosophy that we should care for each other rather than depending on a large, faceless corporation. True health insurance covers guaranteed medical services and charges premiums based on the actuarial risk of people getting sick. Medi-Share states on their website, “Medi-Share is NOT insurance. It’s a New Testament way of thinking about healthcare, built on the principles of Christians bearing each other’s burdens.”
In order to be exempt from the ACA the group must have been in existence since at least 1999 and must submit to an external financial audit each year. The groups are not regulated and have no obligation to pay for medical services. The three largest health care sharing ministries: Samaritan Ministries; Christian Care Ministries’ Medi-Share, and Christian Health Care Ministries. They have been providing medical coverage for their members since the 1990s.
Members pay a “share” each month which is then directed to the members who need the money for medical services. In this way, the members share the cost of medical services among the entire group. One member says “We care and pray for each other as people, not as customers”. Members usually know who is receiving money each month and members are encouraged to pray for these members.
There are some important caveats to programs like these. Members must be Christian and must commit to living a Christian lifestyle which usually includes no smoking, abuse of drugs or alcohol, extramarital sex or use of illegal drugs and may require attending church services. Teenagers must agree to the requirements to be covered.
The benefit to the members is that they can trust that their fellow members are not putting themselves at risk for diseases due to behaviors which the members feel are immoral. Because members decide what medical services will be covered, services which the group does not agree with, such as abortion, are not covered. Medical care needs caused by smoking, drinking alcohol, drug use or promiscuous behaviors are not usually covered. Many preventive services and medical tests for adults aren’t covered and members pay for those out of pocket, although preventive care for young children is usually included.