Health care sharing ministry

A health care sharing ministry is an organization that facilitates sharing of health care costs between individual members who have common ethical or religious beliefs in the United States. A health care sharing ministry does not use actuaries, does not accept risk or make guarantees, and does not purchase reinsurance polices on behalf of its members. Members of health care sharing ministries are exempt from the individual responsibility requirements of the Patient Protection and Affordable Care Act,[1] often referred to as Obamacare. This means members of health care sharing ministries are not required to have insurance as outlined in the individual mandate.[2]

Approximate thirty states have safe harbor laws that recognize healthcare ministries as distinct from health insurance organizations.[3]

History

Health care sharing ministries are founded on the biblical principle of believers sharing each other’s needs.[4] Ministries often cite the mandate of Galatians 6:2 to “Bear one another’s burdens, and thus fulfill the law of Christ” as applicable to medical costs. Some see origins in the Book of Acts where early Christians "were together and had everything in common" and "gave to anyone as he had need", (Acts 2:44-45).[5][6]

Some states have tried to block health care sharing ministries on the grounds that they are selling unauthorized insurance.[7] A majority of states, however, have enacted safe harbor laws specifying that the ministries are not insurance and do not need to be regulated as such. However, the U.S. Department of Health and Human Services issues exemption letters to ministries that have met the criteria to operate independently of the Affordable Care Act.

Membership

According to www.healthcaresharing.org, an alliance of the two largest ministries in the US, over 400,000 Americans participate in health care sharing in 2015, sharing more than $340 million in medical bills annually.[5] A January 2015 op-ed in the New York Times stated that the four main healthcare ministries in the US have a total combined membership of about 340,000, saying that membership has grown recently because of their exemption to the insurance mandate of the Affordable Care Act.[6][8]

The monthly cost of membership in a health care sharing ministry is generally lower than the cost of insurance rates.[6]

Some of the larger health care sharing ministries are: Christian Healthcare Ministries (established around 1981),[9] Medi-Share, a program of Christian Care Ministry (1993),[10] Samaritan Ministries (1994),[11] Liberty HealthShare (1998),[12] MCS Medical Cost Sharing[13] and Altrua HealthShare.[14][15]

Most ministries are oriented toward practicing Christians, with restrictions like abstaining from sex outside of marriage, excessive drinking, tobacco, and illegal drugs. They usually require members to make a statement of belief as well. For instance Samaritan Ministries requires a statement of Christian faith including belief in the triune God and divinity of Jesus; Liberty HealthShare is more inclusive, accepting members with a wide variety of religious and ethical beliefs. All such ministries require that members subscribe to the ethical principles of individually responsibility for health, and helping others in need.[16]

Requirements under the Affordable Care Act

In order for members to be exempt from the tax penalties outlined in the Affordable Care Act, ministries must meet the following qualifications:

Four ministries that meet these qualifications are: Christian Healthcare Ministries, Liberty HealthShare, Samaritan Ministries, and Medi-Share. MCS Medical Cost Sharing, founded after 1999, does not meet the qualifications, but offers to pay the tax penalties incurred by members.[18] Altrua HealthShare, though founded in March 2000 three months after the December 1999 cutoff, has been approved as a health sharing ministry that qualifies members for the penalty exemption.[19][20]

References

  1. Pub.L. 111–148 Sec. 5000A(d)(2)(b)(i)
  2. "The Religious Alternative To Obamacare's Individual Mandate". NPR. Retrieved 2015-05-19.
  3. "Alliance of Health Care Sharing Ministries: State info". Retrieved 2015-05-19.
  4. Whyte, Liz Essley. "Sharing Health | Philanthropic Freedom | The Philanthropy Roundtable". Philanthropy Magazine. Retrieved 2015-05-19.
  5. 1 2 "Alliance of Health Care Sharing Ministries". Retrieved 2015-05-19.
  6. 1 2 3 "Onward, Christian Health Care? - NYTimes.com". Retrieved 2015-05-19.
  7. http://www.washingtonpost.com/wp-dyn/content/article/2005/10/22/AR2005102200046.html
  8. "Banking on faith: Cost-sharing ministries offer Obamacare alternative". The Seattle Times. Also saying that membership has grown significantly in recent years
  9. "Christian Healthcare Ministries: About Us". Retrieved 2015-05-19.
  10. "My Christian Care | CCM". Retrieved 2015-05-19.
  11. "Samaritan Ministries International". Retrieved 2015-05-19.
  12. "Home - Liberty HealthShare". Retrieved 2015-05-19.
  13. "Christian Medical Cost Sharing | Christian Health Care". Retrieved 2015-05-19.
  14. "Altrua Health Share". Retrieved 2015-05-19.
  15. "Health care sharing ministry members share their experiences |". Retrieved 2015-05-19.
  16. "Healthcare Sharing – Mainstream Healthcare Choices". Archived from the original on March 17, 2016. Retrieved March 17, 2016.
  17. Pub.L. 111–148 Sec. 5000A(d)(2)(b)(ii)
  18. "Christian Medical Cost Sharing | No Penalties for M.C.S Members". Retrieved 2015-05-19.
  19. "altruahealthshare.com press release" (pdf). Retrieved 2015-05-19.
  20. "Altrua qualifies for Obamacare exemption, plus more on CMF Curo |". Retrieved 2015-05-19. (Saying that Altrua achieved this via a merger with a smaller but older ministry)
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