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Abstract

Health Care Share Ministries (HCSMs) provide “a health care cost sharing arrangement among persons of similar and sincerely held beliefs.” HCSMs are not-for-profit religious organizations that act as clearinghouses for “those who have medical expenses and those who desire to share the burden of those medical expenses. This Article begins with a survey of the general regulatory landscape for HCSMs. Following that, four key questions about HCSMs structure the rest of this Article. The first question asks, what are HCSMs? To answer that question, this Article examines the basic aspects of the Medi-Share program and the Christian Brotherhood Newsletter. Second, this Article asks, what law applies to HCSMs? In reply, this Article briefly surveys the key elements of insurance law and the law governing HCSMs. Third, this Article asks, how have courts treated HCSMs? To answer, this Article surveys two key state court decisions involving HCSMs. Fourth, this Article asks, how should courts treat HCSMs? To answer the last question, the Article examines U.S. Supreme Court precedent, the legal and logical problems courts and insurance regulators face by forcing HCSMs into insurance law, and lastly examines some important considerations lingering on the sidelines – the freedom of contract, the freedom of religion, the separation of powers, the implications of HCSMs’ status as charitable religious organizations, and federal preemption of the regulation of HCSMs under PPACA. This Article concludes first by examining the epilogue to the Reinhold14 decision in Kentucky and second by providing some general observations and analysis about HCSMs.

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