Three years ago, James Lansberry’s youngest son was born with no movement, no breath and no pulse. 

Doctors were able to get his body functioning within minutes, and quickly sent him to the natal intensive care unit, where he spent the first 11 days of his life before being given the green light to go home. But with this extended medical care, the bills for Lansberry’s wife and son quickly skyrocketed to more than $200,000. And they didn’t have health insurance.

In the weeks that followed, however, cards from hundreds of families throughout the nation arrived in the mail. Each contained notes extending congratulations and offers of prayer and encouragement to the family—and money to help with the family’s financial burden.

“Every single dollar of those bills was paid,” Lansberry tells Citizen.

The massive financial support that poured into the Lansberry home was orchestrated by Samaritan Ministries International, one of the nation’s top three health care sharing ministries (HCSMs), based in Peoria, Ill. Like other HCSMs, Samaritan draws people of faith together and enables them to help one another with their medical costs.

In 1996, Lansbury became Samaritan’s 130th member. Today, he serves as an executive vice president with the member-owned and -operated ministry, which now serves more than 55,000 families and 180,000 individuals nationwide. This February, he said, members were on track to share more than $15 million in medical expenses.

Ever since President Obama signed the Patient Protection and Affordable Care Act into law in 2010, thousands of families have flocked to Samaritan and the other HCSMs as a way out of the expensive federal/state health insurance exchange programs, which generally subsidize elective abortion. 

The Problem with Obamacare

“Obamacare has made it incredibly difficult to find affordable (insurance) that meets people’s needs and respects their values,” explains Sarah Torre, policy analyst for the Heritage Foundation’s DeVos Center for Religion and Civil Society in Washington, D.C..

Earlier this year, Congress sent to the president’s desk for the first time a reconciliation bill repealing significant measures in the health care law. As expected, Obama vetoed it; the attempt to gut the law ended in February when the House of Representatives failed to override the veto.

According to some experts, however, the economic and ethical failures of the law foretell its eventual doom.

“Obamacare is in bad shape—both economically and ethically,” Charlotte Lozier Institute President Chuck Donovan wrote in The Daily Signal on  Jan. 5. “If it were possible for a law to repeal itself, this one would be well on the way.”

Soon after Obamacare took effect, more than half of the health insurance co-ops created by the bill fell apart. Meanwhile, United Health Care, the nation’s largest private insurer, lowered its investment in Obamacare’s state insurance exchanges, announcing that it was likely to pull out of them completely by 2017.

Moreover, the cost of insurance premiums under the law spiked nationwide at the beginning of 2016. In five states—Oklahoma, Hawaii, Tennessee, Alaska and Minnesota—premiums jumped, on average, by more than 29 percent. Minnesota led the nation in premium hikes, seeing an average increase of nearly 48 percent.

On the ethical front, Obamacare continues to challenge pro-life convictions. In 2014, the U.S. Government Accountability Office (GAO) released a report showing that 1,036 health plans offered through the state and federal insurance exchanges created by the program cover elective abortions, even though these plans are eligible for government subsidies. 

Under the Hyde Amendment, passed in 1976, federal law prohibits using tax dollars to fund abortion, except in the case of rape, incest or to save the life of the mother. To circumvent this law, Obamacare requires insurers to collect a “separate payment” of at least $1 from each person buying plans on state exchanges, which will be used to cover elective abortions within the insurance pool. But, as revealed by the GAO report, many insurance companies withhold information from potential consumers about which plans cover abortion.

As a result, many people enrolled in plans on these exchanges pay for other people’s abortions without even knowing it. Lawsuits from pro-life citizens yielded victories in Connecticut and Rhode Island, which now offer pro-life plans that don’t cover abortion—but in Hawaii, New Jersey and Vermont, residents still have no choice but to subsidize abortion through insurance bought on the state exchanges. 

As egregious as that is, the moral problems within Obamacare may soon expand: Last fall, the U.S. Department of Health and Human Services proposed a “Gender Identity Mandate.” According to Roger Severino and Ryan Anderson of The Heritage Foundation, the mandate would force insurers to cover—and doctors to provide—sex-reassignment surgeries “or face discrimination charges and loss of federal funds and Medicaid reimbursements.”

All that, says Torre, is fueling the nation’s “growing interest in alternatives to Obamacare.”

‘A Miraculous Island of Freedom’

Though the Patient Protection and Affordable Care Act is “almost irredeemable,” Lansberry says, it does contain a “miraculous island of freedom.”

The central problem with the law from a constitutional perspective is the individual mandate at its heart—
requiring citizens to purchase health insurance or pay a penalty. However, those who belong to an HCSM are exempt from that mandate.  

According to the law, HCSMs must be non-profit groups made up of people with common ethical or religious beliefs, and they must have been established before Dec. 31, 1999.

According to Politico Pro, there are more than 50 HCSMs nationwide, although most of them are small—for example, churches with less than 100 members.

The nation’s three largest HCSMs are Samaritan Ministries International, Christian Healthcare Ministries and Christian Care Ministry (aka Medi-Share). And, says Charlotte Lozier Institute Associate Scholar Scott Daniels, their memberships have exploded ever since Obamacare became law. By early 2015, these three ministries had more than 310,000 members nationwide—tripling their pre-Obamacare numbers. 

“The growth is strongly correlated with the passage and implementation of the Affordable Care Act,” Daniels says. As his research shows, the largest growth in health care sharing occurred after “the imposition of the individual mandate to purchase health insurance in 2013.”

Although motives are complex, he says, many people are attracted to HCSMs because the monthly costs are often lower than those of traditional health insurance. In fact, his study suggests that savings can range from 45 percent to 60 percent below the cost of health insurance sold in the individual market. Moreover, members can rest assured their money will not fund abortion or other practices that conflict with their religious values.

Yet, as HCSMs insist, they do not provide insurance; instead, they are ministries enabling people to come together and help one another with unexpected medical needs. In some of these ministries, members mail checks directly to other members to help them pay their bills. In other groups, members contribute to a central fund, which is then used to provide for members’ medical expenses.

In any case, the HCSMs themselves don’t take on any risk. They don’t guarantee coverage, nor do they store up reserve funds to ensure that members’ medical expenses will be paid. Additionally, they usually don’t cover pre-
existing conditions, although Daniels says most groups have developed ways to “handle exceptions through voluntary contributions.” Christian Healthcare Ministries is the exception to that rule, as it does provide a way to help cover pre-existing conditions over a period of years.

“You do have to have a willingness to look at health care differently, to look at it the way people used to look at it, which is actually to consider the cost,” says Twila Brase, president and co-founder of the Minnesota-based Citizens’ Council for Health Freedom. “As soon as you start paying out cash, whether it’s yours or the checks that are going to come in, this becomes natural. You weigh everything, you ask questions, you look at all the fine details to see what is going to work for you. It actually is getting back to where it should be.”

This is the key for driving down health care costs, Brase says. 

“The price of health care today does not have to be the price of health care tomorrow,” she explains. “And health-sharing organizations are showing us the truth of the fact that health care does not have to be as expensive as it is today.”

An ‘Uncommon Bond’

Despite this promise of lowering the costs of health care, HCSMs are not without their critics.

“They have the potential to destabilize the market by drawing off the good risk,” Washington State Insurance Commissioner Mike Kreidler told The Wall Street Journal in January. In other words, the generally healthy—and, therefore, less costly—people who join HCSMs are no longer required to contribute their money to the government-run health care system.

Daniels says this criticism is founded upon a secular understanding of community that conflicts with the core rationale behind health care sharing.

“Behind the draping of religious language about the duty to be one’s ‘brother’s keeper’ used in the moral justification for the ACA,” Daniels writes, “lies a secular ideal of communal solidarity. … This ideal partially accounts for the coerced solidarity or ‘shared responsibility’ concept underlying the individual mandate.”

The Christian understanding of community, an all-too-often “uncommon bond” that undergirds the work of many HCSMs, is different.

Christians “understand the law of Christ as God’s purposes for human beings whereby they can achieve the final blessedness only in love of God and of their neighbors,” he writes. “In the end, a precept of self-interest offers no hope of that satisfaction.”

“The secular conception of mutual aid requires state coercion,” he adds, “while the religious conception allows participants to act on voluntary altruism.”

Motivation for the communal “bond” thus comes from within. So Christians “always have a reason to express concern and care for other human beings,” Daniels says.

For Lansberry, this bond is depicted by a stack of cards and notes on his desk, reminding him of fellow Christians who prayed for his newborn son and who voluntarily helped his family pay more than $200,000 in medical bills. Health care sharing, he says, is “about people banding together to do something that no one person could do on his own.”  

For More Information:

Read Health Care Sharing Ministries: An Uncommon Bond, available at http://bit.ly/1QhZSme. Learn more about the Citizens Council for Health Freedom at http://bit.ly/1QhAEdM. Learn more about the three largest healthcare sharing ministries at http://samaritanministries.org, chministries.org and https://mychristiancare.org.

Originally published in the September 2016 issue of Citizen magazine.