With all the uncertainty surrounding healthcare plans made available under Obama's Patient Protection and Affordable Care Act (PPACA), many Americans are wondering if there are any alternatives out there. Or, more to the point, is there any way to opt out of ObamaCare and not pay the penalty for not having medical insurance?
The short answer is "yes". According to this page on HealthCare.gov, you can avoid paying the penalty if:
- You’re uninsured for less than 3 months of the year;
- The lowest-priced coverage available to you would cost more than 8% of your household income;
- You don’t have to file a tax return because your income is too low;
- You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider;
- You’re a member of a recognized health care sharing ministry;
- You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare;
- You’re incarcerated, and not awaiting the disposition of charges against you; or
- You’re not lawfully present in the U.S.
(That same page also lists hardship exemptions.)
This post lists three different ways to "opt out" of ObamaCare, but I'm going to focus on just one: Christian sharing ministries. I am aware of three Christian sharing ministries:
- Samaritan Ministries
- Christian Healthcare Ministries
According to the websites of these healthcare sharing ministries (Samaritan, Medi-Share, Christian Healthcare), each will exempt its members from the penalty for not purchasing health insurance.
When I spoke to a representative at Samaritan Ministries about this exemption, he told me that they are actively lobbying to have "safe-harbor" laws for Christian sharing ministries added to the laws of every state. While a number of states already have positive, explicit legal protection for Christian sharing ministries, a number of them do not. It's still legal for these ministries to operate in states that do not have that explicit protection, but it certainly gives members peace of mind if the necessary laws are in place. For information on whether or not your state has safe-harbor laws for Christian health sharing ministries, click here.
I was also informed by the Samaritan representative about a bill in Congress being sponsored by Aaron Schock, a congressman from Illinois. HR3728 (PDF) makes members of health care sharing ministries eligible to establish health savings accounts. This would be a boon to anyone enrolled in such a ministry, since it would allow them to save money tax-free to help cover the cost of their medical needs.
Of the three ministries, I am most familiar with Samaritan. In a future post, I will provide an overview of Samaritan Ministries. I hope we can follow that up with more information about the other two ministries.
Before we move to the specific health sharing ministries, however, one important question needs to be answered:
Why should you join a Christian sharing ministry, and not simply sign up for ObamaCare like everyone else?
(Please understand that my answer to this question represents my views alone, and not necessarily the views of any other contributors to this blog.)
I think there are a number of compelling reasons to skip out on ObamaCare and join a Christian sharing ministry:
- Cost. Depending on your family situation, it is entirely possible that it will be much cheaper than ObamaCare. Bear in mind that for many people there are two prices for an ObamaCare plan—the actual price, and then the subsidized rate they will pay. In my case, the sticker price for using a Christian sharing ministry will be much higher than the subsidized cost of the cheapest ObamaCare plan. However, many Americans will find that even their subsidized ObamaCare plans will cost them more than their previous health insurance plans, and much more than a Christian healthcare sharing ministry.
- Freedom to choose your medical providers. Depending on the ministry, this is more or less true. Some Christian sharing ministries essentially make you a "self-pay" patient, meaning you can choose to get your medical care wherever you want. The bonus here is more cost savings for you. All hospitals and doctors are willing to negotiate on prices. Although this might sound scary, self-pay patients pay far, far less than the "listed price" for healthcare, and at least one ministry assists a great deal with any negotiations. Also, many healthcare providers are eager to work with responsible self-pay patients, as it means that they are able to collect their money without hassling with insurance companies and government paperwork. Another of the ministries has partnered with a large PPO, again providing a lot of freedom as to where you get your care, and presumably removing the need to negotiate the price. On the other hand, in many places ObamaCare has resulted in few or no choices about where you get your care.
- Quality of care. Speaking of choosing where you get your medical care, this affects quality of care. Numerous top hospitals are opting out of ObamaCare. If you're on an ObamaCare plan, and you want access to a quality hospital that has opted out, you'll simply have to pay out of pocket. (This same principle is at work in the story I told in this post.) And if you don't know, please understand: quality of care as well as outcome can vary enormously from doctor to doctor and from hospital to hospital.
- Opposition to the socialization of healthcare. The success of the PPACA depends on young, healthy, middle and upper class people joining and paying more for their healthcare plans. I don't know what kind of an impact health sharing ministries will have on the success of the whole endeavor, and I suspect it may be small. Still, it's a way to "vote with your wallet."
- Personal responsibility. This may seem high-handed, but that's not my intention. I understand that those who purchase an insurance plan are taking personal responsibility for healthcare for themselves and their family. However, being a self-pay patient forces you to be much better educated about healthcare costs, to shop around, and to negotiate prices. In general, I think self-pay patients will be better informed and more proactive than others. If it's going to impact your wallet, you're going to pay attention.
Are their drawbacks? The answer, of course, is "yes", and I'll try to list those in the reviews of each ministry. Stay tuned.