Samaritan Ministries works hard for the freedom to share Needs

By by Joel Noble  ·  Aug 22, 2023

When Samaritan Ministries began, who knew a small group of Christians helping one another with medical bills would grow into what it is today? With that growth, Samaritan Ministries has had to work hard at both state and federal levels for recognition as a noninsurance approach to health care.

As God has blessed us tremendously with great gains, we continue to work to secure legal standing in all 50 states. Here are some of the ways we’ve made these gains and how that effort continues.

Safe harbor laws

Legal issues can be complex. Because of this, states will allow for certain services or practices under safe harbor laws. What this means for Samaritan Ministries members is that, while we operate and have members in all 50 states and internationally, several states officially recognize that health care sharing ministries (HCSMs) are not insurance and are therefore not subject to state insurance laws. So far, 31 states officially recognize that sharing arrangements are not insurance. More than two-thirds of Samaritan members live in states with safe harbor laws!

Such laws are valuable because they protect HCSMs like Samaritan against hostile regulators who might otherwise bring action against us. One example of this was when an insurance commissioner was asked during a conference of health insurance professionals about regulating ministries like Samaritan Ministries. The commissioner simply stated that the law in her state did not give her that ability, and there was no more discussion.

This is why safe harbor laws are so important. If insurance regulators attempted to subject HCSMs to the same requirements as insurance companies, it would be impossible to meet such standards without destroying the voluntary, ministerial nature of these ministries. And fighting the regulators in court would be extremely expensive and would strain the finances of the HCSM’s membership, who are already a financially stressed segment of the population.

Gains in exemptions

Samaritan Ministries has had great success in negotiating important exemptions in the world of health care.

The exemptions for members of HCSMs in the Affordable Care Act (ACA), for instance, has continued to protect members through states adopting it in their own penalty language. The blessing that the Lord granted in the ACA by exempting members of certified HCSMs from the ACA’s Individual Shared Responsibility penalty was also granted in five of the six states that implemented a mandate. The exception is Vermont, but there’s currently no financial penalty attached to their mandate.

Then there’s the NCAA college sports exemption.

Most institutions of higher education require students to buy health insurance from the school they’re attending or to prove they have insurance elsewhere. Thankfully, throughout the years, hundreds of institutions have accepted Samaritan Ministries membership in lieu of their health insurance requirement. However, if a student was an NCAA athlete, they were required by the NCAA to purchase insurance, even if the school accepted health care sharing.

In late 2016, I met with NCAA representatives. After our discussion, they had a better sense of how health care sharing programs work and directed their governance and membership affairs staff to begin accepting membership in an HCSM to meet NCAA requirements, a practice which began the following year.

Praise God for removing such a significant obstacle for many Samaritan families!

State tax deductions

For the past 16 years, members in the state of Missouri have enjoyed the ability to deduct all ministry-related amounts they pay each year when calculating their taxable income on their state income tax return. And for several years we have been working to extend that to other states.

We were successful!

Capital building

Starting with tax year 2023, Indiana residents who are members of health care sharing ministries will be able to deduct their Shares and fees on their state tax returns.

Success in Montana

Another success on the state level happened years ago involving Medi-Share, when the state of Montana required them to cease operation in the state, contending that they were unlicensed insurance.

As part of our partnership with Medi-Share in the trade association Alliance of Health Care Sharing Ministries, we worked to pass a safe harbor law that would explicitly recognize in the state code that HCSMs are not insurance and would allow Medi-Share to operate again in Montana. Safe harbor legislation was passed in two legislative sessions but was subsequently vetoed by two different governors.

This was an unfortunate setback, but the story wasn’t over. The political environment changed in Montana. The newly elected commissioner of Securities and Insurance allowed Medi-Share back into the state, and the new majority party added safe harbor legislation to their agenda. A Montana safe harbor law was passed in 2021, and in 2023, the Legislature expanded the definition of an “eligible medical expense” in a Montana medical savings account to include health care sharing expenses.

Building relationships

I regularly attend conferences alongside state legislators and regulators including the National Council of Insurance Legislators, the National Association of Insurance Commissioners, the American Legislative Exchange Council, and the National Conference of State Legislatures, along with numerous other events.

The relationships built at these events allow us to educate policymakers about Samaritan Ministries and other HCSMs. Potentially harmful regulations that were being considered, or already proposed, in states including Texas, Hawaii, Illinois, and Ohio were averted by simply talking to elected officials. Additionally, several of the safe harbor laws that have been passed started with interactions at these meetings.

Grassroots is key

While the relationships I build are important, the work of our members is even more important. The thousands of emails and phone calls that you have made over the years in response to our grassroots campaigns have made the difference time and time again, helping to get a piece of legislation a hearing or ultimately having it passed or defeated.

Beyond the grassroots, our “grasstop” members have been instrumental in our legislative work. Every two years, following the national election cycle, I survey our members to identify any relationships they may have with elected officials. These relationships, be it with a relative in office or someone they share a pew with, has allowed them to share their own Samaritan stories in a personal way that resonates with these officials.

God has blessed us through legislative and regulatory gains over the years. And Samaritan Ministries continues to work hard to ensure that health care sharing ministries can keep serving the Body of Christ with minimal government intrusion, allowing members freedom in health care choice.

Joel Noble works in the Public Policy Department at Samaritan Ministries.