Healthcare Insurance is one traditional route to covering medical costs, but some turn to what is described as an alternative to insurance with Health Care Sharing Ministries (HCSM). An HCSM is an organization in which health care costs are shared among members with similar ethical or religious beliefs.
Basically, instead of relying on insurance to help cover medical care costs, the HCSM share medical expenses among members who contribute to help other members cover medical costs. Insurance companies have the corporate resources to cover medical care costs, while HCSM organizations rely on a network of ordinary citizens to help pay for their medical expenses that isn’t 100 percent guaranteed.
HCSM programs have existed for decades in the U.S., traditionally serving small insular communities, including the Amish and Mennonites, until a significant change in the 2010 Affordable Care Act. This legislation included a loophole exempting uninsured people from paying a tax penalty as long as they were a member of an HCSM.
This option was appealing for anyone opting out of Obamacare, and some HCSM programs have targeted conservative members against Obamacare. One HCSM group, Liberty Health Share, promoted their services to conservative audiences at the American Conservative Union (CPAC) 2021 and sponsored several Trump rallies with their logo printed on the stage backdrop.
The criteria for HCSM programs required the program to be tied to a religious organization before 1999, and new ministries would abuse this loophole by affiliating themselves with previously existing churches. HCSM programs exploded in popularity following a legal loophole of Obama’s individual care mandate stopped being enforced during the Trump administration.
The popularity of these HCSM programs exploded from 200,000 members recorded from one decade ago to more than one million members today. The margin in the difference between insurance and HCSM decreased as HCSM programs attempted to model themselves similar to insurance plans.
HCSM might seem similar to insurance but don’t have to abide by the same insurance products regulations, including not being required to cover pre-existing health conditions. They also are not required to cover essential services under the ACA, including treatment for substance abuse, mental healthcare, routine care, maintenance care, stabilized care, preventative, and wellness care.
With no requirements for HCSM programs can deny coverage based on morality, they can deny coverage for any reason. With no guarantee of coverage, most HCSM programs have thousands of complaints on the Better Business Bureau (with a majority not being BBB accredited) confirming the loose guidelines of HCSM programs with some members not being reimbursed for medical care despite being pre-approved.