While many Americans are struggling to navigate healthcare.gov and some are fighting against the Affordable Care Act’s threat to religious liberty, an estimated 100,000 people are exempt from the legislation as members of a health care sharing ministry (HCSM); these organizations offer the opportunity for individuals with similar beliefs to share their health care costs.

HCSMs are not panies, but nonprofit religious organizations that receive no government funding. Andrea Miller, the medical director for Medi-Share, one HCSM in the U.S., explained in a recent interview with NPR how the ministry works:

[I]t’s a group of people, in this case Christians, who band together and agree that they want to share one another’s burdens. And the way they do that is that they each put a certain amount of money aside every month and then they actually send that money to another Christian who is in need of it that month in order to help them pay their medical bills.

The Alliance of Health Care Sharing Ministries explains, in more details, what HCSMs are and offers some interesting facts about them, including parison of current ministries. More than 99% of all applicants are accepted into a sharing ministry. Medi-Share, has shared more than $600 million among members. HCSMs have stricter guidelines than traditional panies on which procedures are eligible. For example, members will not receive sharing to pay for abortions, suicides, and other procedures that are prohibited in ministry guidelines. Members must live Christian lifestyles, abstaining from illegal drug consumption, sex outside of marriage, tobacco use, and may not abuse alcohol or prescription drugs. Because HCSMs are not panies they don’t have to guarantee that they will pay any and all medical bills. Members pay a one-time participation fee, pay a monthly share option, and receive a newsletter or publication that lists the needs of other members. Members must be Christians, affirming their faith through a personal testimony or with a letter from their pastor.

HCSMs have been providing this service in the United States for several decades, but the two largest organizations—Medi-Share: Christian Care Ministry and Samaritan Ministries International—have been working since the early nineties. HCSMs take their mission directly from scripture. Galatians 6:2 calls Christians to “bear one another’s burdens, and thus fulfill the law of Christ.” They also cite Acts 2:44-45, which is often mistakenly attributed to munism: “all the believers were together and had everything mon. Selling their possessions and goods, they gave to anyone as he had need.” Participants of HCSM see paying for each other’s medical bills as bearing one another’s burdens.

The two main HCSMs distribute the funds among members differently. America’s Christian Credit Union manages all funds in a “Member Share Exchange” for Medi-Share and money from there can be transferred from one member to another. Members of Samaritan Ministries International give their monthly share amount directly to other members in need based on their monthly newsletter. When members have needs that do not meet the guidelines or are not paid in full, they can be listed in the monthly newsletters and other members may choose to donate extra funds.

Members not only support each other financially, but also spiritually through prayer and sending words of encouragement. Fred Bennet, from Chattanooga, Tenn; had been a member of an HCSM for several years when he and his wife Beth suffered major health problems. Beth had E.Coli in her kidneys and ended up with a $70,000 bill while Fred suffered a heart attack and had to have several surgeries, other members of their sharing ministry picked up the bill and the Bennetts ended up paying only the deductable for each procedure. While the financial aid is important, the spiritual support offered by HCSMs is also vital. Fred says: “The night before my surgery, the lady who’d helped me locate the right providers and everything called me back and said, ‘Would it be OK if I prayed with you for your surgery tomorrow?’” Two members from Idaho, Michael and Mary Suitter, say that they “found [themselves] in tears as we read the meaningful notes of agape love and encouragement” from other participants.

Although individual participants of HCSMs are exempt from Obamacare for now, it could still cause long term problems for individual members as well as the ministries as a whole. A recent article by Jim Epstein at Reason outlines the risks that Obamacare poses to HCSMs. Epstein says:

It would hardly be the first time that a new government entitlement destroyed a voluntary organization built monly held beliefs.Samaritan is one of the last “mutual aid societies,” organizations that up to the early twentieth century played an integral role in American life.In 1910, an estimated one-third of American men belonged to a fraternal organization, which provided temporary help to those unlucky enough to fall ill or lose a job. The mutual aid societies began disappearing with the rise of government programs such as welfare, Medicaid, food stamps, and unemployment insurance.

The demise of Samaritan and other outfits like it would be cause for concern. Subsidized health insurance plans through the exchanges provide richer benefits than a membership in Samaritan, but they do away with incentives that over time are the key to driving down prices and driving up quality. With the “silver plan” on the health care exchanges, when patients get a routine physical they’re responsible for no more than $45 out of pocket and insurance pays the rest. Samaritan members pay the entire cost of a routine visit out of pocket and they can only submit their bills for reimbursement that exceed $300.

President of Samaritan Ministries, James Lansberry, is not concerned that members will leave Samaritan and other HCSMs for Obamacare, he says: “We look at our exemption from the individual mandate as a miracle from God…members will stick with us even if it doesn’t make financial sense, because by belonging they’re expressing their religious beliefs.”

Acton has plenty of resources to help you understand what’s going on with health care in America. Check out Powerblog posts about Obamacare, Nick Pandelidis’ mentary “Obamacare Reset: A Free Market Vision for Health Care Reform,” and Acton’s “Christians and Health Care” Resource page.