An important exemption

So much attention has focused on negatives with the new healthcare law that one plus in the legislation has gone largely unnoticed: Congress allowed healthcare sharing ministries to continue by exempting members of these plans from 2014's insurance mandate.

"It pleases me that they did something that reasonable, that sensible," says Catherine Sumners, a resident of northern Arizona who is a member of Christian Healthcare Ministries (CHM) in case she has a serious accident."They're allowing people that are doing something that works to continue using it. I'm wondering how come they're not encouraging people to form more of these groups."

More than 35,000 households participate in the three largest healthcare sharing ministries, which collectively have paid more than $1 billion of medical expenses since the mid-1990s.

Although technically not insurance-a number of states force these plans to include disclaimers with any mailers or public statements-they function in similar ways. Costs and options vary widely, with deductibles, rules on preexisting conditions, and other guidelines that fill dozens of pages.

The little-noticed provision in the federal legislation was an outgrowth of the exemption written in the Senate version. When the House rushed to adopt the Senate bill to avoid further debate, it turned its back on its original intent-not to recognize sharing plans.

The legislation defines them as tax exempt, 501(c)(3) organizations whose members share a common set of ethical or religious beliefs and share medical expenses without regard to residence or employment. It also requires them to have been in continuous existence since Dec. 31, 1999, which includes the three largest Christian plans:

• Christian Healthcare (formerly the Christian Brotherhood Newsletter) of Barberton, Ohio; launched in 1982.

• Christian Care Medi-Share (CCM), a program of Christian Care Ministry of Melbourne, Fla.; started in 1993.

• Samaritan Ministries International, based in Peoria, Ill.; founded in 1994.

When President Barack Obama was a member of the National Black Caucus of State Legislators, Christian Care's executive director, Rev. Howard Russell, addressed the group at its meeting in Little Rock, Ark., in December 2007. A year later, the group adopted a resolution recognizing the contribution of such plans and urging states considering universal coverage to ensure residents retained the option to participate in them. "That endorsement was very helpful," Russell said.

He sees the caucus action as important to the exemption's inclusion in the Senate bill two years later. Russell credits Sens. Max Baucus, D-Mont., and Charles Grassley, R-Iowa-who agreed on the exemption prior to their public political split.

"If there was one version we needed to be in, it was the Senate version," says Robert Baldwin, president of Christian Care Ministry, noting that the exemption can serve as a recruiting tool in the next three years.

Members serve as the best recruiters for healthcare sharing groups, and people like Sumners are happy to oblige. She has been unable to work after she developed a hypersensitivity to certain chemicals, and her condition hasn't been resolved with conventional medications (she does find herbal remedies helpful). Sumners uses a low-cost, high-deductible plan that would only kick in if she got seriously ill. "It gives me peace of mind to know that if I end up in a hospital for emergency care I'll be OK."

Jodi Swiderek is another CHM member who hasn't relied on it for any major expenses but appreciates the security. When she and her husband made a midlife career change, they were looking at more than $600 a month for COBRA-related coverage. That is more than double the cost of their monthly sharing expense.

"It's perfect for us because we can afford the small doctor bills," says Swiderek, who works part-time for a juvenile court agency in Madisonville, Tenn. "Before, it was scaring us to death that if we had some kind of test, surgery, or disability, we would go broke."

When patients do face major surgery, these plans often come through. That is what CCM member Michael Bristol discovered after he needed brain surgery in 2007. The surgery and related expenses have totaled over $800,000. Through it all, the small business owner from Vero Beach, Fla., never worried about coverage.

"We know the bills would be taken care of," Bristol says. "It's not only biblical, it's practical. It's a group of Christian believers who are taking care of one another. Not just people helping one another through sharing the blessings that God's given them, but praying for one another."

Like the 95 percent of members who Baldwin says are relieved that healthcare sharing ministries can continue, Bristol calls the federal exemption from the insurance mandate a "blessing."

"It's fortunate that we didn't have to fall under the bill," says the co-owner of a computer sales and service company. "We don't even know everything that's in it."