My Experience with a Christian Health Care Sharing Ministry
Why we're getting out, and why we need healthcare for ALL in this country
Welcome to the Trauma-Informed Take, where we talk about mental health, parenting, Christian nationalism and religious trauma, exvangelicalism, and the various culture-related intersections… like HEALTH INSURANCE COVERAGE offered by strict conservative Christians! Is it fun*? Is it a party*? Read on to find out!
*No, and no.
After having paid our dues to a religious healthcare cost sharing plan for almost 4 years, we’re making our escape – right as the Christian nationalists begin imposing their will on the rest of us across the country. Some escape, it feels like.
How it all began
When we moved to Ohio in 2018, we had very few choices about how to have health insurance. My husband and I were both employed by his church at that time, and they were unable to offer us insurance. I’m no stranger to that: in my dozen years since graduating college, I’ve had employer-sponsored insurance for exactly two of them (and Medicaid for several of them).
This article is also about how we desperately need a new way to provide healthcare in our country. I hate the fact that we tie health insurance to predominantly full-time employment -- and only certain full-time employment, at that. It puts millions of us in difficult positions wondering how to get coverage. Also, insurance companies seem mainly interested in collecting as much profit for CEOs’ pockets as possible, so I’m also not saying commercial health insurance for everyone is the solution for all our problems, either.
At any rate, 2018 was smack in the middle of Trump’s presidency, and Trump had vowed to do his best to take down Obamacare. That had a real impact on us, as we were faced with very few options for insurance in our rural area.
In this predicament, we reluctantly decided to join one of those Christian health care sharing plans where they specify very clearly they are not insurance. Members sign off that they adhere to certain beliefs, pay a monthly fee, and request reimbursement from the organization if they happen to have a health issue. These organizations carefully articulate that they’re not obligated to reimburse members, but because the members operate out of Christian love and compassion, that is all the guarantee one needs.
Yes, so literally, you have no legal recourse if something goes wrong and they decide not to cover your costs. You operate on faith and goodwill that they will reimburse you the amount they say they will, but if they choose not to or they run out of funds to do so… you are SOL.
This is where I’ll offer my disclaimer that it did work for us. I felt uncomfortable with it because of all the issues I’m about to cover below, but they treated us well. I had two healthy, uncomplicated pregnancies and births that were essentially fully reimbursed by them. Customer service was nothing but polite whenever I had to speak with them. I’m not mad at any rank-and-file individuals there.
My problem, however, is how these organizations are set up to take advantage of our healthcare system and especially the exclusionary practices regarding who they are willing to cover.
How they take advantage of our system
As a member of the ministry, you present yourself to healthcare providers as a self-pay patient, in order to get the lowest rates possible. The kicker, of course, is you’re not actually self-pay (except for when you are, for things they don’t cover). The self-pay rate is significantly less than the insurance rate.
They’re also selective about who they cover. If you have a pre-existing condition, it is not eligible for coverage (unless you have a year without symptoms or treatment and you’re “cured.” Maintenance of a condition doesn’t count as cured). More on selectivity below...
Finally, the program can operate the way it does because it relies on the rest of our medical system to care for people who fall in the gaps. So, the ministry can decide to just cover people who are healthy at the outset, exclude a bunch of treatments they don’t want to pay for, and depend on the U.S. healthcare system to take care of the most ill and vulnerable. If that’s not reliance on socialism (while decrying it yourself), what is??
Exclusionary practices
Now, the exclusionary practices. Members must sign a statement of faith saying they are Christian, active members of a church, and live their life by “biblical principles.” Of course, what they mean when they say that is entirely different from what I mean when I sign my agreement.
My biblical principles include: radical inclusivity and hospitality, justice for the poor and marginalized and oppressed, suspicion of kings and empires and those in power, and not being afraid to make a little noise to disrupt unjust systems, a la Jeremiah, Ezekiel, Micah, and Jesus. Maybe not what they meant??
Yeah, definitely not what they meant. I only realized how explicit they were about this when we were already into our second baby’s pregnancy and too late to back out: they say you have to believe that marriage is between a man and a woman. For this article, I went searching on their website for the exact quote but could only find oblique references to it. I can’t prove this, but I wonder if it’s because they are trying to avoid potential lawsuits, so only people already part of the ministry have direct access to their Statement of Beliefs?
I still feel horrible about staying in and “agreeing” to that belief. I used my privilege of being in a heterosexual marriage to obtain coverage for healthcare, including expensive maternity costs, and had to pretend to believe something I don’t believe in order to do that. Judge me all you want – I'm already doing it to myself. [hides face in shame]
Lots of limits on what they cover
The plans don’t cover any routine wellness visits, expecting you to self-pay for those (and we did). No vaccines are covered, and if you’ve had a baby, you know how many vaccines they’re supposed to get that first year of life. And no substance abuse treatment or mental health coverage is offered, either.
Maternity needs, however, are fully reimbursed. So long as you are on the highest-tier plan (sure, totally reasonable), and got pregnant at least 30 days after you joined the ministry (yes they will count the days from your due date to make sure), oh and of course are in a heterosexual marriage.
There are literally specific clauses in the handbook about only reimbursing maternity needs for married women. If you’re a single woman who finds herself pregnant, they will not pay for any of your needs, claiming instead that there are “other programs” available to help aid with maternity care costs.
Yup, so Mary, the mother of Jesus, would not have been offered coverage.
The biblical principles that I follow most certainly would NEVER exclude a single pregnant woman from maternity care coverage. My principles would encourage “judge not lest ye be judged,” not casting the first stone, and bringing into the fold the disempowered – with many women among them.
So much for the pro-life policies I’m sure they believe so strongly in – so strongly that they will offer zero coverage to a single woman who genuinely wants to carry her pregnancy and keep the baby. Because they disagree with the “morality” of her decisions (they are making, of course, a whole lot of assumptions here).
But I digress.
Trouble conceiving? Don’t dream that any IUI or IVF coverage will be offered. Don’t want to conceive? Birth control is definitely not covered – whether pills / IUDs / etc or vasectomies or tubal ligations. You’re on your own for that. And it’s beyond obvious that abortions are not covered. If you have a miscarriage and require a D&C (coded as abortion but is a medical procedure to remove fetal tissue after a miscarriage, to prevent the woman from going septic), I’d guess you’re hung to dry on that one, too.
A happy ending?
So after 4 years of paying in and benefiting from coverage, we’re getting out, and I have mixed feelings of relief to leave, guilt for having participated, and anger that we’re an incredibly wealthy nation but our healthcare and insurance systems are so broken.
Also, my family has “real” health insurance now, thanks to Obama, Biden, and the Marketplace…so that’s nice.
The real cherry on top [NOT] is that as I mentioned above, the celebration sours because even though we’re leaving the Christian plan I ethically disagree with, the country is getting taken over by Christian nationalist extremists bent on forcing the country to believe what they do. Including around intimate healthcare decisions.
I just hope we still have places to escape to when it’s all said and done.
Well, on that sad note: here’s an informative yet entertaining video by John Oliver that does a great job explaining exactly why health care sharing ministries are a con and a drain on our resources!
Have you encountered problems with insurance coverage, or lack thereof? What kinds of solutions have you tried to stitch together? Do you have any ideas for how to save our healthcare system in the US? Leave me a comment - I’d love to hear your thoughts!
When I started teaching, educator insurance was pretty great. I remember feeling that I didn’t care how much I got paid as long as I had that insurance. Since that time, it has been changed and chopped into little bits so much that teachers get the short end of the stick for both pay and insurance. I would definitely support healthcare for all, no matter how rocky the road is to get there.
So, I'm going to figure out some insurance stuff this week. I'm still on my parents' insurance because it's really good, but their insurance plan is specific to VA and so it doesn't work the same way in Washington state. Apparently there's something called "guesting" where certain doctors are contractors who will take my insurance, and I've thankfully found one, but I'll also need to figure out getting a referral to an endocrinologist and a psychiatrist....it's probably going to be a bad time. I'm probably going to make a lot of phone calls, which I hate.