Health Care Sharing Ministry Memberships More Than Double Since ACA Passage

Published April 7, 2016

As health insurance premiums and deductibles rise under the Affordable Care Act (ACA), more families are turning to insurance alternatives known as health care sharing ministries (HCSMs) to defray health care costs.

More than 311,000 adults and children in 66,000 households participated in the three largest HCSMs in December 2015, writes Scott E. Daniels in a study by the Charlotte Lozier Institute. Under the ACA, enrollment in an HCSM exempts members from the “individual mandate,” the law’s requirement that people who choose not to purchase health insurance be fined up to $695 per adult and $2,085 per family in 2016 for that decision, Daniels writes.

As medical needs arise, members typically pay a portion of their expenses—similar to a deductible—and forward their bills to their HCSM or directly to fellow HCSM members, who pay monthly “shares” of approximately $200 per individual or $500 dollars per family.

Voluntarism and Efficiency

Dale Bellis, executive director of Liberty HealthShare, says reliance on the participation of willing members distinguishes the HCSM model from those of insurance companies.

“Medical insurance pools money and builds reserves from consumers and makes promised payments based on certain risks,” Bellis said. “Medical cost sharing relies on the participation and contributions of individual members to meet the medical costs submitted by members.”

Under the ACA, for-profit insurance companies must maintain a medical loss ratio of not more than 20 percent, meaning they must spend at least 80 percent of revenue collected through premiums on patients’ medical bills. Bellis says Liberty HealthShare’s nonprofit status ensures greater efficiency.

“Because we are nonprofit, we avoid the profit-motivated bureaucratic middleman approach to healthcare cost management,” Bellis said. “We put health care decisions in the hands of the individual member, restoring the patient-doctor relationship. Our administrative expense target is 12 percent, which means 88 percent of dollars contributed monthly are directed to sharing the medical expenses of our members.”

Membership Rising Rapidly

Bellis says Liberty HealthShare’s membership more than doubled in 2015 and participation in HCSMs overall has ballooned since President Barack Obama signed the Affordable Care Act into law in 2010.

“At passage of the ACA, nationwide healthcare ministries represented less than 100,000 families,” Bellis said. “Today, there are approximately 250,000 families nationwide, representing 600,000 individuals, cost sharing with a health care sharing ministry.”

Membership in Samaritan Ministries, an HCSM founded in 1991, surged from 15,000 households in 2010 to more than 56,000 households—182,000 adults and children—in January 2016, WORLD News Group reported.

The ACA has made traditional health insurance less affordable and less appealing to many Americans, while sharing services in general are growing more popular, says Anthony Hopp, Samaritan’s director of membership development.

“More and more people are beginning to share in a lot of creative ways by using services like Uber and Airbnb,” Hopp said. “So the idea of sharing medical needs doesn’t sound so fringe anymore, but instead it’s becoming a preferred and logical choice.”

Principle Over Price

Although monthly membership in HCSMs costs less than most insurance plans, Hopp says some members choose to share costs for reasons unrelated to price.

“Samaritan members are like-minded Christians who agree to and sign a basic statement of faith,” Hopp said. “Our approach of directly sharing medical needs is steeped in prayer, community, and trusting God. Members are joining primarily on principle, not price. It’s a biblical health care option that is consistent with their religious beliefs.”

Bellis says some of Liberty HealthShare’s members sought out the HCSM because they are “men and women of faith and values” who wish “to live out their individual faith beliefs exempt from the requirements and mandates within the ACA [regarding] abortion, abortifacients, contraceptives, [and] gender reassignment.”

Voluntary Contributions

Unlike other HCSMs, Samaritan asks its members to send checks directly to fellow members who have applied for reimbursement for a medical bill.

“To remain a member in good standing, a person is required to send his monthly share to the person to whom he is directed,” Hopp said.

Samaritan members’ direct contact with one another helps the organization cover preexisting conditions.

“When a medical need is preexisting,” Hopp said, “Samaritan members are asked to consider voluntarily sending a little extra beyond the assigned monthly share, such as $20 to $25, in order to help the person with the preexisting need. We call these Special Prayer Needs, and throughout our 22 years of sharing, we’ve been so encouraged to see the Body of Christ come together to help with these preexisting burdens.”

Jenni White ([email protected]writes from Oklahoma City, Oklahoma.

Internet Info:

Scott E. Daniels, “Health Care Sharing Ministries: An Uncommon Bond,” American Reports Series, Charlotte Lozier Institute, December 2015: