Hundreds of thousands of American families currently have no medical insurance yet know that their health-care needs are covered. They have joined one of the four major “health-care sharing ministries” now operating across the U.S., the earliest of which was formed in 1981.
These religious nonprofits allow their members to share the costs of each other’s medical needs, without the commercial mechanisms of insurance. Inspired by ancient Christian practices of burden sharing and mutual aid, each of these groups requires enrollees to make a profession of Christian faith, and to avoid smoking, alcohol abuse, and other practices they deem incompatible with faithful Christian living. These requirements cement the personal commitment, communal feeling, unity, and trust that have allowed these voluntary networks to thrive.
The lifestyle pledges also help contain expenses, as does the prudence with which members seek care, knowing that fellow believers will be asked to share all bills. The monthly costs of health-care sharing ministries tend to be half or less of what comparable commercial insurance would require. Each ministry operates differently, but all involve a considerable degree of personal contact and mutual support. People send notes and prayers along with the checks they mail to families in health crises, which participants cite as one of the great satisfactions of their voluntary pooling of medical needs.
These ministries have proven quite practical, flexible, and effective, with billions of dollars of reimbursements having taken place since their creation. When the Affordable Care Act was written in 2009, with penalties for parties lacking insurance, health-care sharing ministries were granted an exemption. The organizations have experienced record enrollments in the years since.
- Philanthropy magazine reporting, philanthropyroundtable.org/topic/philanthropic_freedom/sharing_health1