While the individual mandate requires ever American to have health insurance, there is a big exception to the Affordable Care Act that more and more people are taking advantage of.
Health care sharing ministries are the exception, and they are becoming popular among Texans of faith, as profiled in this article from KERA Dallas.
The two largest ministries, Smaritan and Medi-Share, have nearly doubled membership in Texas since the Affordable Care Act was signed.
Health care sharing ministries are not actually insurance. You can think of it as a group of people who agree to share the cost of each other’s medical bills either by contributing something similar to a premium or responding directly to other members’ claims. There is no guarantee that the ministry will cover medical expenses.
They also have unique requirements. For instance, members must attend church and abstain from extramarital sex and alcohol and drug abuse.
The ministries are not regulated as insurance, so many elements of the Affordable Care Act, such as requirements to cover essential health benefits or to accept patients with pre-existing conditions, do not apply. Additionally, insurance experts say health care sharing ministries do not fall under consumer protections applicable to insurance, such as those concerning accountability and financial solvency.