Health care sharing ministries (HCSM) are organizations in the United States in which health care costs are shared among members with common ethical or religious beliefs in a risk-pooling framework in some ways analogous to, but distinct from, health insurance.
Members of health care sharing ministries are exempt from the individual mandate requirement of the U.S. Patient Protection and Affordable Care Act of 2010 (the individual shared responsibility provision was repealed in December 2017, effective in 2019). This means members of health care sharing ministries were not required to have insurance as outlined in the individual mandate, which was later repealed.
Approximately 31 states have safe harbor laws distinguishing healthcare ministries from health insurance organizations. Some of the larger health care sharing ministries are Christian Healthcare Ministries (founded in 1981), Medi-Share, a program of Christian Care Ministry (1993), Samaritan Ministries (1994), Liberty HealthShare (1998, originally established by Mennonites), United Refuah HealthShare, MCS Medical Cost Sharing Altrua HealthShare, Freedom HealthShare, Unite Health Share Ministries, and Trinity HealthShare (1997).
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