Amid rising healthcare costs and premiums, more people are turning to health-sharing ministries as an alternative to insurance plans offered through the Affordable Care Act exchanges or employers.
In 2014, when the ACA went fully into effect, about 160,000 people were enrolled in these faith-based programs, PBS NewsHour reported. Since then, the number of enrollees has grown to as many as 1 million.
These ministries have limited government oversight and have far more freedom to reject applicants with pre-existing conditions or claims that don't meet moral standards, according to the article. Experts warn that the growth of these programs can further weaken the ACA's marketplaces.
"You've got healthy people pulled away into these alternative products—health-sharing ministries just being one of them—leaving a sicker risk pool for insurers that continue to abide by ACA rules," Sabrina Corlette, of Georgetown University's Center for Health Care Reform, told PBS. "It's, unfortunately, a negative spiral."
Insurance brokers are also increasingly pitching health-sharing ministries, Politico reported. At least three of the largest ministries pay brokers fees to encourage them to suggest their products as an insurance alternative.
The ministries are also downplaying their Christian roots to attract more enrollees, according to the article. Some require members to sign forms that show they will follow certain faith-based rules, and others prohibit smoking, drinking and birth control. But few are actually checking in on whether the people enrolling in their ministries are Christians.
"We are an unabashedly Christian ministry," Dale Bellis, executive directory of the ministry Liberty HealthShare, told Politico. "We don't monitor an individual's faith commitment—how many times they attend church or what they're doctrinal beliefs are."
Some of these ministries are making their products more attractive by offering updated technologies and new ways for members to connect with the services. Samaritan Ministries International, for example, has launched eSharing, which allows members to digitally send notes, prayers and their financial contributions to one another.
“As both the digital world and the healthcare landscape change rapidly, we want to continually offer our members new and more streamlined ways to send their shares directly to other members, which is a practice unique to Samaritan Ministries,” said Anthony Hopp, Samaritan’s vice president of external relations, in the announcement.
The growth in health-sharing ministries comes amid growing interest in association health plans. The Trump administration is betting big on the latter as a way to reduce insurance costs, proposing a rule that would expand who could form those associations. But experts warn that, similar to the ministries, these plans aren't required to meet the consumer protections outlined in the ACA.