Mandates hurt ministries

WASHINGTON-In his September 9 address to Congress, President Barack Obama attempted to impose some pragmatism into the rocky healthcare debate.

"If you come to me with a serious set of proposals, I will be there to listen," he claimed to a throng of lawmakers who responded to the speech with applause, boos, and one shout of "You lie!" "My door is always open."

That promise should have had advocates of innovative, patient-centered Christian healthcare groups jumping out of their seats.

Representing about 34,000 families and growing, these healthcare sharing ministries (HCSMs), in which a pool of believers share their insurance costs, are pouring their limited resources into lobbying efforts to ensure they are not left out of a final healthcare overhaul.

But they are facing a long road.

Currently, the federal government does not recognize Samaritan Ministries International, Christian Care Medi-Share, and Christian Health Care Ministries as official health insurance providers. That's bad news if Congress passes a bill that includes mandates requiring individuals to purchase federally approved insurance plans. Such mandates are gaining wider bipartisan acceptance and are expected to be a part of any changes.

"We are looking at complete obliteration of the ministries as they exist," warned James Lansberry, the president of the Alliance of Health Care Sharing Ministries.

The groups did not succeed in getting language protecting such organizations into the 1,000-page House healthcare bill that has already passed committee.

But Martin Hoyt, a lobbyist for the groups, said he is more hopeful about prospects in the Senate where the bill details are still being hammered out and have yet to go through the committee gauntlet.

The alliance has submitted suggested protection language to the Senate Finance Committee's bipartisan "Gang of 6" currently trying to hammer out a consensus. But such protection provisions were missing in Finance Committee Chairman Max Baucus' preliminary outline.

These groups should be worried: Mandates would grant broad new enforcement powers to the Treasury Department, which would be tasked with collecting the penalties for individuals and employers who forgo government-approved insurance.

"The mandate is going to be a bigger problem than people think," worries Lansberry. "It's a backdoor reduction in our freedom to make individual healthcare choices."

Alan Crandall, a Presbyterian minister and member of Samaritan Ministries, said he is unwilling to pay into the typical health insurance offered by his employer, which covers abortions. He instead believes that HCSMs are a practical application of the New Testament ideal of Christian community, which is to help provide for the needs of one another in the body of Christ.

Crandall said they do not seek any special favors from the state: "We only seek the freedom to continue without restriction to obey Christ's command to love one another in this area of medical needs."

All three HCSMs operate on a monthly membership amount that is determined by each family's or individual's needs. The monthly fees are not sent to the ministry but are instead shared directly with fellow members who have medical costs. The HCSMs track the medical needs and direct where the membership money should go. If each member is paying $125 per month, for example, and one member has a $10,000 cancer bill, then the HCSM would send a letter to 80 of its members telling them to send their monthly check to that cancer survivor to cover the expense.

"We're looking to have support from both parties, so we would like to see this proposed by both a Republican and a Democrat senator," said Hoyt, a Federal Affairs Representative for the alliance.

Many healthcare sharing members are in lower income brackets and rely on the HCSM alternative because of its low-cost. If forced into purchasing health insurance by a federal mandate, they would most likely be able only to afford a government-funded option. Employers also would not be able to recognize HCSM as a viable option and would require their employees to pay into a federally approved insurance option.

Moving away from a healthcare sharing ministry would violate the convictions of many HCSM members. Currently members have the opportunity to know where their money is going every month within a ministry they support. A public healthcare option, however, would likely define abortion and other controversial practices as "healthcare" that could be covered under the funding.

"It's important that as Christians we look for reforms that put the patient in the driver's seat, and HCSMs are one way we can be doing that," Lansberry said. Jacob Parrish contributed to the reporting for this article.