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That’s likely due to a combination of factors: Affordability (compared to plans available on ACA exchanges) has been a big draw for new members, as well as the appeal of belonging to a community that shares similar values. The ACA , for example; Christian sharing ministries have no such obligation. Some people simply didn’t like feeling compelled by the government to purchase insurance. In a post about the ACA, one evangelical blogger , “When we do not have the real freedom to choose or we want to spend our earnings and care for our own person and family, we are in bondage.” To people who feel similarly, health care sharing ministries present themselves as not only a feasible option, but a desirable alternative.

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In this issue of the Review, we explore the intersection of community development and health

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Legally, ministries are not insurance providers, so there are no laws regulating who they must accept as members or which costs they cover — just a social contract between their members. Pre-existing conditions can disqualify someone from membership, while lifetime reimbursement caps and religious restrictions might mean that some members’ medical needs aren’t, in fact, reimbursed. These ministries are, to many, a straightforward blessing: a cheaper alternative to insurance and an extra assurance that their money is not going toward abortions. Many of the members I’ve spoken with are very happy with the care they receive and have found these ministries to be a source of security and community. But for others, like the Olsons, the relationship is not so simple. That’s because the stated Christian mission of these ministries doesn’t always match the reality of what they offer in the face of real, painful need.

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In response, First Family Ministries hosted a community discussion Monday about the issue

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I asked a representative of Christian Healthcare Ministries how they would respond to a difficult situation in which, say, a member was raped and needed assistance with maternity expenses. “For things outside the control of our members, we will look at it individually and with an attitude of mercy,” said Lauren Gajdek, Christian Healthcare Ministries' communications director. “CHM would support someone who was raped and pregnant. We are a ministry. The criminal would be held accountable to the extent of the law and CHM would coordinate with the family and all applicable resources to assist the victim.”

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Insurance is far from perfect — unwieldy, expensive, and often byzantine in its structure. Disputes are common and there is no guarantee of fairness. Yet the contract involved with insurance exists to protect consumers. In signing up for health care sharing ministries, those consumers are legally agreeing to be financially responsible for all of their own medical bills, while hoping that their community of Christians won’t leave them in a desperate situation. A popular saying in evangelical churches is that everyone — even atheists — has faith. It’s what we put our faith in that differs.

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