Enrollment in health-sharing ministries is allowed under the Affordable Care Act, provided the ministries existed before the year 2000.
Membership in the three largest health-sharing ministries – Samaritan Ministries International, Christian Care Ministry or “Medi-Share,” and Christian Healthcare Ministries – has risen significantly since 2013, jumping from around 190,000 members nationwide to over 311,000 at the end of 2014, according to the pro-life Charlotte Lozier Institute, the research arm of the Susan B. Anthony List.
The three ministries combined saw a total of $253 million in health care costs in 2015.
The author of the report on the ministries, Scott E. Daniels, credited their rising popularity in part to families’ desires to pay only for insurance coverage they need.
There’s also a demand for alternative health care providers spurred by the health care law’s individual mandate and its “values,” he added.
The “values” of the Affordable Care Act are not just abortion coverage and contraception mandates, Daniels insisted at the Heritage Foundation panel, but a much broader “secular ideal of communal solidarity” that coerces everyone into buying insurance so there are no “free riders” in society.
Health-sharing ministries are a response to these “values,” he added, because they do promote a community, but a “devoutly Christian” one of “bearing one another’s burdens” and “mutual aid,” without coverage that members would object to subsidizing like abortions and contraceptives.
In 2014, a government watchdog report found that in federally-subsidized health plans on the public exchanges, insurers were not billing abortion coverage separately, thus leaving open the possibility of federal dollars going to cover elective abortions.
“We need to go back to what we were as an early Christian community,” said Louis Brown, the director of CMF CURO, a Catholic health-sharing ministry that has partnered with Samaritan Ministries. This means “accompanying each other in all aspects of our life” and ensuring that the Lord is “Lord over everything” including health care.
CMF CURO was launched in October of 2014 as an alternative to the insurance exchanges set up under the Affordable Care Act. It partnered with Samaritan Ministries to ensure compliance with the health care law, since only health-sharing ministries created before 2000 are accepted as legal substitutes for insurance.
Aside from the monthly premiums or “shares,” members cover up to $300 of each medical need as their way of contributing. The cost of needs are generally shareable among members – excluding pre-existing conditions and preventive care – from $300 up to $250,000.
Sometimes a person may have to pay more than $300 up front for medical costs. In these cases they may pay that amount and be reimbursed later by other members for the costs exceeding $300.
The ministry encourages everyone to negotiate their costs with providers, with the help of Samaritan Ministries. CMF CURO can also send members a reference price – 125 percent of the Medicare cost of that service -- that is fair to both patient and provider, with the help of a price administrator who works with the ministry.
Members can also use a CMF CURO debit card so when they receive shares from other members to pay for medical costs, the money goes straight to the debit card and not as a check in the mail. The card is usable only for medical services.
There is no reimbursement for morally-objectionable services like abortion, contraceptives, or in-vitro fertilization. Families cover one another’s medical needs along with personal notes and prayers.
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Participants must live a healthy, Christian lifestyle: regular church attendance and no drug abuse and sexual immorality. They also must abstain from tobacco use – except for a special cigar or pipe smoke – and must submit a yearly recommendation from their pastor.
Most pre-existing conditions aren’t eligible for reimbursement unless “the condition appears to be cured” and a year has passed “without symptoms, treatment, or medication.” For more serious problems like Type 1 diabetes or a previous bout with cancer, the waiting period is longer.
Someone with these problems could conceivably enroll and rely upon the generosity of other members to cover their needs, however.
The ministry now has members in 48 states. 55,000 households have now enrolled with Samaritan Ministries.
For two families, the biggest factors in their decision to switch from the private insurance market and the exchanges to CMF CURO were the high cost and the Christian ethos – “conscience and cost,” as one member put it.
“The most immediate benefit has been cost-saving,” said Tim Mayer, a Catholic father of three from Manassas, Virginia.