Christian sharing ministries offer controversial alternative to traditional health insurance

With health insurance premiums on the rise, consumers always are hunting for ways to cut costs. For the religiously faithful, “sharing ministries” long have been an alternative to traditional health insurance.

Members of these ministries share each others’ medical bills on a monthly basis; the programs offer low monthly expenses and few limits on pre-existing medical conditions.

While the savings can be substantial, members of these ministries must be willing to stick to Christian principles and must have faith in an unregulated health care sector. Some state insurance regulators have scrutinized these sharing ministries. However, the ministries stress that they are not insurance companies.

The Kentucky Department of Insurance and the Kentucky Attorney General’s Office secured a court order in March 2011 barring one of the ministries — Melbourne, Fla.-based Medi-Share — from doing business in the state.

About 100,000 Americans obtain health care coverage through Christian sharing ministries rather than through traditional health insurers.

State officials won their argument that Medi-Share is an unauthorized health insurer; the legal fight dates back to 2002. Medi-Share maintains it’s a “sharing program” that should be exempt from state regulation. Kentucky authorities say Medi-Share can’t operate in the state unless it obtains the proper certification or qualifies for an exemption under state law.

Sharing the medical burden

Roughly 100,000 people belong to the country’s three main Christian sharing ministries. Members pool their resources, make monthly “share” payments and spread their medical bills — and the financial risks — among the group. James Lansberry, executive vice president of Samaritan Ministries in Peoria, Ill., says his organization has more than 16,000 households with 50,000 members who share about $4 million in medical bills each month.

Lansberry, who also is president of the Alliance of Health Care Sharing Ministries, says members share each other’s medical bills at a fraction of the cost of health insurance. Monthly shares at Samaritan are relatively low: $135 for singles, $270 for couples, $200 for single-parent families and $320 for two-parent families.

Members send their shares (or portions of them) directly to members with particular needs who are listed in each monthly newsletter. A system of checks and balances makes sure that each member pays a fair share every month. When a member needs to pay a medical bill, help comes from across the country.

“My wife had her appendix out four years ago. We received notes and cards from 21 different states, and over 100 people shared that burden with us,” says Lansberry, who was a member before becoming executive vice president.

Robert Baldwin, president of Christian Care Ministry — sponsor of the Medi-Share plan — says his organization has 13,500 households that share more than $3.7 million in medical bills each month. The monthly share, the equivalent of an insurance premium, is set as low as possible while still putting enough money in the pool to pay claims. All of the ministries negotiate discounts with health care providers.

“Generally, we average a 30 to 40 percent discount on those larger bills. It’s a fairly quick turnaround. You’ll get the checks, cash them and then pay your medical bills,” Lansberry says.

The country’s third major sharing ministry, Christian Healthcare Ministries, says that in the past 20 years, its members have shared more than $500 million in health care costs — costs that have been lowered thanks to those discounts.

At Barberton, Ohio-based Christian Healthcare Ministries, “we do not pre-certify or pre-authorize any treatments, procedures or hospitalizations. Those decisions are between our members and their health care providers,” the Rev. Howard Russell, executive director of the nonprofit, says in the group’s March 2011 newsletter.

A representative of Christian Healthcare Ministries couldn’t be reached for comment.

Religious principles come into play

All three of the major sharing ministries are based firmly on Christian ideals and principles. Members must profess to being a Christian (according to biblical principles) and sign a statement of faith. This can be in line with any Christian denomination, including Catholicism, Lutheranism and Presbyterianism.

Members of Christian sharing ministries must adhere to ideals and principles based on biblical quotes and teachings.

“We ask members to sign off on a basic statement of faith of any Christian denomination. It’s rooted in the principle of sharing and that we all should take care of one another,” Lansberry says.

With that acknowledgment also comes the responsibility to abide by Christian principles. Member guidelines are derived from biblical quotes and teachings — meaning that, among other things, members must abstain from using tobacco and illegal drugs and must agree not to abuse legal or prescribed drugs. They also must swear off any sexual activity outside a traditional biblical marriage and agree to adopt good health practices.

Baldwin says the three ministries also place a great emphasis on healthy living. His ministry has “health coaches” who work with members over the phone to help them make better lifestyle choices regarding everything from fitness to illness.

Limitations and regulations

Sharing ministries are not without limitations. They do not cover usual routine maintenance, visits or tests. Lansberry says anything less than $300 typically must be paid out of a member’s own pocket. Certain things may not be covered if they don’t fall in line with Christian principles. For example, a single pregnant woman seeking prenatal care or a man wanting treatment for a chemical addiction likely would raise red flags.

Lansberry says the sharing ministry concept does work, “but we don’t think it is for everyone, and we want to make sure people understand what they are getting involved with before they do it.”

Regarding the Kentucky case against Medi-Share, Lansberry says he doesn’t think it will set any sort of precedent in other states. “I would think that if there were going to be problems in other states related to the Medi-Share case in Kentucky, we would have seen them by now,” Lansberry says.

The Kentucky decision doesn’t affect Christian Healthcare Ministries’ or Samaritan Ministries’ operations in that state. Both organizations are protected by Kentucky’s “safe harbor” insurance provision.

The federal health care reform law exempts members of health care sharing ministries from complying with the new insurance mandate. Sharing ministries emphasize that they are not insurance companies, as doing so would open them up to regulatory requirements.

John Greely, a spokesman for the Texas Department of Insurance, says the Lone Star State doesn’t have any problems with sharing ministries as long as they don’t represent themselves as insurance companies. The biggest concern, Greely says, is that unlike the traditional insurance industry, the lack of regulation of sharing ministries could harm consumers. For instance, traditional insurers must have a certain amount of capital on hand, while sharing ministries are not bound by that financial requirement.

“It could be iffy for the consumer. There is not that assurance there that you have when you are dealing with a regular insurance entity,” Greely says.

–Craig Guillot