Alaskans opt out of insurance, turn to health care sharing ministries

As health insurance rates rise out of reach for many Alaskans, some residents are turning to an alternative — Christian Health Care Sharing Ministries. The religiously affiliated organizations are legal under the Affordable Care Act. Members pay a monthly fee and are eligible to have medical expenses over a certain amount reimbursed. It’s not insurance, but it’s an appealing option for Alaskans priced out of the individual insurance market.

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When Lane Chesley first heard about health care sharing ministries, the idea sounded too good to be true. The Homer resident had just received notice from Moda Health that the insurance rate for him and his wife Melody was increasing to more than $2,000 dollars a month:

“We were put in a position where we really have no choice but to opt out of the traditional insurance because we just simply can’t afford the premiums in the individual market,” he says.

Chesley doesn’t regularly attend church, but he started researching the Mennonite-affiliated Liberty HealthShare, based in Ohio. For a monthly contribution of $300, he and his wife can access shared funds from the health ministry for medical expenses over $1,000 per incident. The ministry handles bills and negotiates rates with providers. Chesley was impressed enough to pass on the information to other friends in Homer facing the same predicament:

“We all started Googling ‘health share ministries’ to see if we could find articles or information about how these health share ministries have failed their members and we couldn’t find any,” he says.

And Chesley’s research didn’t stop there. He called up his wife’s cousin, Timothy Jost, who also happens to be a health reform expert at Washington and Lee University in Virginia.

Jost told Chesley, ‘Yeah, this might be your best alternative’ — but there is some risk. Health care sharing ministries are not insurance, so they aren’t bound by strict government regulations for insurance. For example, they aren’t required to have cash reserves to help ensure they stay solvent. The ministries are also free of some Affordable Care Act rules — they can impose maximum benefit amounts and screen members for pre-existing conditions to help manage costs.

And Jost says he’s worried the ministries will struggle as they grow:

“Historically, the health care sharing ministries have functioned very well, but historically they were not terribly big and also were limited to people who really felt strongly about their mission and their beliefs,” he says.

Liberty HealthShare has had a big jump in membership this year. Executive Director Dale Bellis says the nonprofit has added 1,000 members per month since the start of 2015 and now has about 30,000 members nationwide. Bellis says that growth is manageable.

“Its been a fun challenge,” he says.

Some health care sharing ministries require members to attend church regularly and even ask for a letter from a pastor as proof. Bellis says Liberty HealthShare doesn’t “intrude on personal faith choices.” He says the organization does ask members to agree to treat their bodies as temples, a core belief that also helps contain health care costs.

“We ask that you accept our shared beliefs, and it’s essentially wrapped around the values that say that God has given us our rights, and we have the moral and spiritual responsibility to care for our bodies and help others when they’re in need,” he says.

Lane Chesley and his wife became members of Liberty HealthShare starting Nov. 1. Chesley looked at it like a math problem. If he and his wife went uninsured in 2016 they would pay a penalty of about $4,000. It didn’t cost much more for the couple to join Liberty HealthShare:

“The math just seemed to stack up to say it’s worth a try, regardless of whether I get anything reimbursed or not. Because I have a legal mechanism now where I don’t have to pay $36,000 for health insurance.”

Even though he’s not a part of it anymore, Chesley worries about the future of Alaska’s individual health insurance market. With healthy people like him and his wife opting out, that will leave a smaller pool to cover health care costs for those who remain. And that could drive already unaffordable rates up even higher.

This story is part of a health reporting partnership between APRN, NPR and Kaiser Health News.