A health care option that’s an alternative to traditional insurance has been growing in popularity in Iowa and across the country.
Members of so-called health care sharing ministries write checks every month to cover the health care bills of other members, without the guarantees and oversight of traditional insurance.
Even more Iowans are expected to enroll now that some premiums under the Affordable Care Act have skyrocketed.
Renee and Dan Welk in Des Moines are both self-employed. The get their health insurance through the ACA’s individual marketplace.
They’re among some 22,000 Iowans who recently got bad news about their monthly premiums.
“I think they quoted over $1200 before the price increase, so we're thinking about $1700 to $1800 a month,” Welk said. “So that led us to thinking, what else is out there?”
As Welk searched the internet for options, health care sharing ministries came to her attention.
Since the ACA, more and more new members have joined the groups, either to bypass Obamacare’s individual mandate altogether or to avoid high premiums.
News has spread by word of mouth and radio ads.
“You can save a lot of money by switching today to MediShare, but you’re also making a difference in the lives of others,” said one ad that aired on Christian radio in Iowa.
For years, MediShare and other similar programs have charged monthly payments that are generally lower than insurance premiums, currently as little as $400 a month for a family.
MediShare coordinates the payments so they go directly to cover other members’ health care bills.
“The MediShare program has been around since 1993, and in that time our members have shared more than $1.2 billion in one another’s medical expenses,” said Director of Marketing and Communication Michael Gardner. “Our members value the fact that they’re joining a like-minded community of people.”
Gardner says the program helps Christian follow a biblical mandate to share one another’s burdens. To sign up, members attest to their Christian faith and regular church attendance.
On any given month, MediShare covers roughly $25 million in medical bills. Over the program’s history, two bills were covered that exceeded a million dollars.
The ministries are exempt from the ACA, so preventive care and pre-existing conditions are not covered. Neither are expenses incurred through questionable behavior like drinking.
James Knight, a dentist in Fort Dodge, has been a member of MediShare for 18 years. The program covered the cost of his $325,000 cancer treatment.
“It’s significantly cheaper for us than traditional health insurance,” Knight said. “It's a sharing organization whose members are all Christians and want to live their lives by biblical principles.”
Bill Kurth, an attorney in Lake City, has been a long-time member of another health-care sharing organization known as Samaritan Ministries. He said he joined for two reasons.
“The first one was that I would be sending a check each month to a set group of people who had a medical need,” Kurth said. “I would be sending them a prayer along with it, a card along with it.”
Secondly, Kurth said, his monthly check wouldn’t pay for abortions.
Kurth has convinced friends in Lohrville and Rockwell City to join. He says it's clear he's spent less on health care over the years than he would under a traditional insurance plan, even though he's paying for his own preventive care.
"I have no doubt that I have spent substantially less," Kurth said.
Officials say the promotional materials make very clear the ministry is not insurance and there is no guarantee that bills will be covered.
“We’ve seen the members continue to meet the needs every single month for our entire history, but that doesn't mean that there are any guarantees or obligations that go along with insurance,” said Samaritan Ministries V. P. James Lansberry.
Iowa Insurance Commissioner Doug Ommen confirms there is no oversight by state regulatory authorities, although the groups file with the IRS as non-profit organizations.
“I expect it will work as long as it works,” Ommen said. “It is something that right now especially with the high rates that individuals are facing will be a place where people will go.”
Officials say enrollment in the ministries nationwide doubled and then doubled again after the Affordable Care Act. Iowa enrollment in Samaritan Ministries has tripled to about 4,000 members today. MediShare had 571 Iowa members in 2012. That has reached nearly 3000 today.
Meanwhile, Renee Welk recently learned her premiums under the Affordable Care Act won’t be as high as earlier estimated. So she’s doing the math to see what’s most affordable.
But it’s not just a financial decision.
“I feel better about paying a monthly amount to families in need than to helping insurance companies and CEO’s make over $20 million a year,” Welk said.
And she says now that there’s another option, she likes the thought of doing without the government assistance that Obamacare provides.
“It’s kind of an ego thing,” she said.