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
Lua error in package.lua at line 80: module 'strict' not found. 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. Still ministries have been criticized for the lack of regulation and the occasional misappropriation of funds such as a case in 2000 when a ministry's officials had fraudulently spent $15 million on personal luxury items.
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 an 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]
Tax penalties 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:
- Must be a 501(c)(3) organization
- Members must share common ethical or religious beliefs
- Must not discriminate membership based on state of residence or employment
- Members cannot lose membership due to development of a medical condition
- Must have existed and been in practice continually since December 31, 1999 (a grandfather clause)
- Must be subject to an annual audit by an independent CPA which must be publicly available upon request[17]
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
- ↑ Pub.L. 111–148 Sec. 5000A(d)(2)(b)(i)
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- ↑ http://www.washingtonpost.com/wp-dyn/content/article/2005/10/22/AR2005102200046.html
- ↑ Lua error in package.lua at line 80: module 'strict' not found. Also saying that membership has grown significantly in recent years
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- ↑ Pub.L. 111–148 Sec. 5000A(d)(2)(b)(ii)
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- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found. (Saying that Altrua achieved this via a merger with a smaller but older ministry)
