Members find lower cost and good feeling in helping one another
Whether or not President-elect Donald J. Trump is successful in his quest to repeal and replace Obamacare, about 300,000 Americans are likely to continue getting their healthcare by sharing the costs with others.
Membership in healthcare sharing ministries (HCSMs) has doubled over the past five years, according to Joel Noble, vice president of the Alliance of Healthcare Sharing Ministries. Many members—mostly Christians—are so committed to the principle of sharing one another’s burdens that changes to the Affordable Care Act are unlikely to adversely affect their membership.
“We were fortunate to have the exemption written in under a Democratic Congress,” Noble said, referring to a provision exempting HCSM members from the ACA’s requirement to purchase health insurance. HCSMs are not insurance but an arrangement in which a member’s healthcare costs are paid by other members. “We’re optimistic that a Republican Congress will be just as friendly.”
Noble said that if the ACA is repealed, his organization will lobby for a definition of health care sharing ministries to be written into any new legislation.
Not only is membership in HCSMs growing; the number of ministries have also been increasing. The Alliance represents the three largest ministries: Samaritan; Medi-Share, and Christian Healthcare Ministries. But there are several smaller ones, including two that are Catholic: CMF-CURO and Solidarity.
For many people, affordability is a key motive for signing up, particularly when healthcare insurance premiums rise dramatically.
“The prices for our monthly premiums skyrocketed in late 2013, and we could no longer afford health insurance; and we were already needing to consider additional coverage because we wanted to grow our family as well,” said Anthony Keiser, 31, who has three small children with his wife, Janie. “We applied for Medicaid, tried to enroll in the health exchanges on healthcare.gov, and were denied in both cases.”
The Keisers, who live in Tulsa, Okla., kept hearing about Medi-Share and Samaritan Ministries from friends and acquaintances. “Serious skepticism led me to think it was too good to be true,” Keiser said. “We felt we were out of options, though, and we did the research. Samaritan seemed to fit our needs better, and we were glad to know they had been around a long time and had the highest membership.”
He was worried about big healthcare costs, however, and another child was on the way. Happily, he said, everything from prenatal to postnatal care was covered.
The biggest drawback to using Samaritan, Keiser said is “the additional work that it takes to go through all of the bills, to know what everything costs, and to sometimes have to speak to multiple people in the billing department; especially if errors in calculation are made.” Samaritan asks that members negotiate prices with healthcare providers. “I could see how many people would just rather show the insurance card.”
At the same time, Keiser said, having to talk with doctors and hospitals about costs was “really illuminating about just how expensive it all can be, and how mistakes can be made, or additional costs can be added that are either wholly unnecessary or simply did not happen.” He said he found a “serious error in calculation on the part of the hospital business office” that added about $2500 to the bills for their child’s birth.
Patrick Watkins and his wife of 15 years were also fed up with traditional health insurance, though they stayed on it long enough to have their seventh child recently. “We’ve had battles with insurance companies every single year. Every single child. You name it. They didn’t want to pay,” said Watkins, a business analyst in Kansas City, Mo. “Our son had hernia surgery. They didn’t want to pay it because they required your primary health provider give a referral before anything can happen, and we didn’t have the referral because our PHP had left his practice and was unreachable at the time. They eventually paid it, but those kinds of battles I was just so sick of fighting—spending hours and hours and hours fighting these huge companies, whose first reaction is not to pay because enough people will lose heart and give up.”
Significantly, the Watkinses’ daughter was diagnosed with Type 1 diabetes recently, and the costs involved—an ER visit, transport to another hospital, a day and a half in ICU, and a week on the endocrine floor—would have amounted to $75,000 to $80,000. Because the family is self-paying, they are considered “uninsured,” so the hospital gave them a 50% discount. All of it was paid by the Samaritan sharing ministry.
Unfortunately, neither prescriptions nor diabetic supplies after 120 days are covered. “This is significant, like a second mortgage significant,” he said.
Michael McClelland and his wife, Karen, who live in Ann Arbor, faced something similar with Medi-Share. They were on Blue Cross, but toward the end of 2015, they learned that their premiums would be jumping significantly. So they switched.
Unfortunately, after only three months on Medi-Share, one of their children was diagnosed with Type 1 diabetes. Medi-Share informed them that they wouldn’t cover it because it’s a chronic condition.
“Happily, the state of Michigan has a program for conditions like this,” said McClelland, who works in real estate development. “I don’t know if I could keep Medi-Share were it not for this state program.”
There are other factors that appeal to HCSM members, such as a tangible sense of helping others in need and the fact that their premiums are not being used to cover morally objectionable drugs or procedures.
“We don’t have to worry about where our money is going, what sort of immoral things this money being used for,” Watkins said. “They won’t cover things that are anti-biblical lifestyle according to their charter. ”
That includes abortion, contraceptives, transgender surgery, assisted suicide and a growing list of other objectionable procedures.
“I’m actually giving money to someone in need and the overhead is fairly low,” said Kamilla Ludwig of Colorado. “I can direct my own healthcare. I can go to a specialist when I feel I need to.”
Likewise, Susannah Pearce signed up for CMF Curo with “the knowledge that what I would pay each month directly pays the medical needs of a person or family, rather than enriching an industry I don’t like…. My monthly check truly is helping my neighbor. It could be considered almsgiving.”
Open enrollment, the annual three-month period when people can enroll in an insurance plan through the Health Insurance Marketplace, runs until January 31, 2017.