The landscape of healthcare can be complex, especially for individuals and families seeking options that align with their faith and values. Health care sharing ministries (HCSMs) have emerged as a potential alternative to traditional health insurance, appealing to those seeking community-based, faith-driven solutions. Among these, A Catholic Health Care Sharing Program holds particular significance for Catholics looking to integrate their religious beliefs with their healthcare decisions. However, recent events within the HCSM sector underscore the importance of careful consideration and due diligence when choosing a program.
The dissolution of Sharity Ministries, formerly Trinity HealthShare, serves as a stark reminder of the potential pitfalls within the health sharing ministry model. This faith-based ministry, which once boasted 40,000 members, declared bankruptcy and liquidated its assets, leaving a substantial number of members burdened with unpaid medical bills estimated between $50 million and $300 million. This situation, highlighted by reports in Christianity Today and class-action lawsuits, has prompted scrutiny from state regulators who questioned Sharity’s operational practices as an unauthorized insurance provider.
Katy Talento, executive director of the Alliance of Health Care Sharing, an industry trade group, publicly supported the regulatory actions against Sharity, emphasizing that Sharity was never part of their alliance. The Alliance of Health Care Sharing Ministries advocates for high standards and accountability within the HCSM industry to protect members and maintain the integrity of these faith-based programs.
Unlike conventional health insurance, where premiums are pooled and managed by an insurance company, health care sharing ministries operate on a different principle. They facilitate a system where members voluntarily share each other’s medical expenses. This model often resonates with individuals drawn to the biblical concept of bearing one another’s burdens and supporting fellow Christians in times of need. Approximately 1.5 million Americans participate in health care sharing ministries, with around $2 billion in medical expenses shared in 2020 alone. The U.S. Department of Health and Human Services recognizes over 100 such organizations as certified health sharing ministries under federal law.
Like many of its counterparts, Sharity Ministries based its membership criteria on Christian religious beliefs and commitments to avoid risky behaviors. Members contributed monthly payments, anticipating that their own medical costs would be covered in turn. This system was often promoted as a more affordable alternative to traditional health insurance, sometimes claimed to be half the cost.
However, the reality for Sharity members diverged sharply from this promise. Court documents from late 2021 revealed over $300 million in outstanding member claims. Joe Guarino, former president of Sharity, expressed surprise at the escalating figure of unpaid claims, indicating a potential lack of transparency and financial mismanagement within the organization. A lawsuit from the State of California in 2022 further alleged that Sharity Ministries allocated a mere 16% of member premiums towards medical expenses, raising serious concerns about their operational efficiency and commitment to their members’ needs.
While a liquidation trust has been established to distribute remaining funds, it is anticipated that members with unpaid medical bills will only recover a small fraction of what they are owed. Sharity attributed its financial woes to its vendor, Aliera, a for-profit entity that has also faced legal challenges, including a fraud conviction in 2020 and subsequent bankruptcy proceedings.
The Alliance of Health Care Sharing Ministries stresses the importance of upholding “minimum standards for member ministries to preserve integrity and accountability.” Katy Talento confirmed that “Trinity/Sharity was never a member of the Alliance,” highlighting a crucial distinction between ministries that adhere to industry best practices and those that operate outside established frameworks of accountability. The Alliance collaborates with seven of the nine major nationwide health sharing ministries that are federally certified, promoting responsible and ethical operations within the sector.
During the COVID-19 pandemic, health care sharing ministries played a significant role for their members, facilitating the sharing of millions of dollars in medical bills related to COVID-19 diagnosis and treatment, illustrating the ongoing need and function of these faith-based communities.
For individuals considering joining a catholic health care sharing program or any health sharing ministry, the Alliance recommends several key steps to ensure they are choosing a reputable and reliable option. Firstly, verifying if the ministry possesses a certification letter from the U.S. Centers for Medicare and Medicaid Services confirming their compliance with Affordable Care Act standards is crucial. Secondly, inquiring about membership in the Alliance of Health Care Sharing Ministries can provide an additional layer of assurance.
Solidarity HealthShare stands out as a prominent example of a catholic health care sharing program. Rooted in the Melita Christian Fellowship Hospital Aid Plan, with historical ties to a Mennonite community, Solidarity HealthShare operates as an independent ministry specifically catering to the Catholic community. It offers plans designed to align with Catholic ethical and moral teachings, notably excluding coverage for procedures such as contraception, sterilization, abortion, and assisted suicide, which are contrary to Catholic doctrine. Solidarity HealthShare emphasizes a member-centric approach, enabling individuals to share healthcare expenses based on demonstrated need within a framework consistent with Catholic values.
Kevin J. Jones
Alt text: Kevin J. Jones, senior staff writer at Catholic News Agency, expert on healthcare and Catholic news.
Brad Hahn, CEO of Solidarity HealthShare, affirmed their commitment to providing “affordable, reliable healthcare options” in light of the challenges faced by some ministries. He emphasized that Solidarity HealthShare facilitates access to healthcare providers of the member’s choice while actively negotiating for transparent and reduced costs for medical services. In 2021, Solidarity HealthShare facilitated the sharing of over $30 million in medical expenses, achieving a reported cost savings of 67%, highlighting their operational efficiency and financial stewardship.
Hahn stressed Solidarity’s dedication to “transparency and accountability,” noting several governance and accounting safeguards in place to ensure responsible operations. These include management by a volunteer-majority board of directors, a compensation committee, and annual audits conducted by an independent auditor adhering to accepted accounting principles. Solidarity HealthShare is also undergoing an accreditation process with Demotech, a financial analysis firm, further demonstrating their commitment to external validation and operational rigor.
Member contributions to Solidarity HealthShare are managed through member accounts at an established credit union, acting as a fiduciary, ensuring funds are exclusively used for sharing medical expenses. This financial structure provides an added layer of security and transparency for members.
Despite the benefits and faith-based alignment offered by programs like Solidarity HealthShare, it is important to acknowledge criticisms of health care sharing ministries as a whole. Joann Volk, a research professor at Georgetown University’s Center on Health Insurance Reforms, a critic who has published research through The Commonwealth Fund, points out that while HCSMs may resemble insurance and sometimes have lower upfront costs compared to unsubsidized marketplace plans, they operate outside the regulatory frameworks and consumer protections that govern insurance plans.
Volk emphasizes that unlike insurance, HCSMs do not guarantee reimbursement, even for claims that meet their guidelines. Data from Massachusetts-based ministries in 2019 and 2020 revealed that the percentage of member contributions allocated to health care claims varied significantly, ranging from 16% to 111%, contrasting sharply with legal requirements for insurance plans to allocate a much higher percentage to healthcare costs.
Further research by Volk and colleagues in 2020 examined exclusions in several nationwide health sharing ministries, including Samaritan Ministries, Medi-Share Christian Care Ministry, Christian Healthcare Ministries, and Liberty HealthShare. These ministries often impose dollar limits on costs, exclude pre-existing conditions or enforce waiting periods, and restrict maternity service payments. Many also exclude maintenance medications for chronic conditions and offer limited coverage for mental health or substance-use disorder treatments. The exclusion of contraceptive coverage, while appealing to some on religious grounds, is viewed by critics like Volk as a limitation on essential healthcare for women.
The Alliance of Health Care Sharing Ministries advocates for “robust disclosure” from HCSMs to potential members, clearly outlining the differences between membership and traditional health insurance. They also recommend public reporting of audits and administrative overhead, independent governance, and comprehensive guidelines to ensure ethical and responsible operation of health sharing ministries.
For Catholics seeking a catholic health care sharing program, understanding both the advantages and potential risks is crucial. While programs like Solidarity HealthShare offer a faith-based approach to managing healthcare costs within a supportive community, the failure of Sharity Ministries underscores the necessity for careful evaluation. Choosing a program that prioritizes transparency, accountability, and adherence to industry best practices, such as membership in the Alliance of Health Care Sharing Ministries and robust financial safeguards, is paramount to ensuring that your faith-based healthcare sharing experience is both ethically sound and reliably supportive.
