Pregnant and Uninsured? Discover the Shocking Costs That Could Leave You with $20,000 in Bills!

Alycin Berry’s experience navigating the U.S. health care landscape sheds light on a growing trend among families seeking affordable health coverage. In early 2018, after her husband started a new job, the couple faced exorbitant health insurance premiums—more than they could reasonably afford. With no major health conditions and the recent birth of their first child, Berry felt the need for maternity coverage but found traditional health insurance out of reach.

In search of alternatives, the couple chose a health care sharing ministry, a model touted as a more affordable substitute for traditional insurance. They paid hundreds of dollars each month, significantly less than conventional premiums. However, this option came with caveats. Members had to adhere to specific religious values and sign declarations that aligned with those beliefs. For instance, the ministry would not cover pregnancies conceived via in vitro fertilization, a stipulation that did not concern Berry since she identifies as Catholic. “It did feel like it was comparable to health insurance if not better than health insurance,” she recalled, citing the ministry’s advertised maternity benefits.

However, the reality of using that coverage proved challenging. After experiencing a miscarriage in 2019, Berry sought reimbursement for follow-up care. The process involved extensive paperwork, including proof that her pregnancy did not result from fertility treatments, and took several months. “We’re grieving this loss, we’re jumping through hoops to get this miscarriage care covered,” she said, highlighting the emotional toll of dealing with bureaucratic hurdles during a difficult time.

Berry's story is not unique; it reflects a broader trend where families are turning to health care sharing ministries as a response to rising health care costs. As Congress debates extending subsidies for plans under the Affordable Care Act (ACA), the expiration of tax credits will likely lead many consumers to seek cheaper alternatives. Data from the Kaiser Family Foundation (KFF) shows that about 25 million Americans relied on these marketplace plans last year, but preliminary figures suggest enrollment has already dropped by at least 1.4 million due to rising premiums.

Despite the allure of lower costs, health care sharing ministries operate outside the ACA's consumer protections. Unlike traditional insurance, they are not required to cover certain essential health benefits such as maternity care, preventive services, and mental health treatments. JoAnn Volk, a research professor at Georgetown University’s Center for Health Insurance Reforms, explains that as costs rise, sellers of alternatives to comprehensive coverage capitalize on the opportunity to present their options as more affordable.

Ministries work on a theoretical sharing model, where members pool resources to cover medical expenses at the discretion of the organization. This means a lack of transparency and significant limitations on coverage. Many ministries refuse coverage for services that conflict with their religious beliefs, notably impacting women and LGBTQ+ individuals who may face denial for contraception or treatment related to non-heterosexual relationships.

The Alliance of Health Care Sharing Ministries has seen enrollment soar since the ACA came into effect over 15 years ago, largely due to an explicit exemption that allows people using these ministries to bypass the individual mandate for insurance coverage. Current estimates suggest that over 1.7 million Americans are enrolled in these ministries, though some reports indicate the actual number may be higher, as many arrangements encourage members to seek charity care before submitting bills for reimbursement.

“There’s an ongoing affordability crisis in health care that is being made worse by the lapse of this extra premium help, so people are looking for options,” notes Katie Keith, head of the Center for Health Policy and the Law at Georgetown University’s O’Neill Institute. “Some brokers sell ministries, and people don’t realize that it is not a typical health insurance product.”

While some states have taken steps to regulate these ministries, others have explicitly stated that they do not equate to insurance, which frees them from many oversight requirements. In Massachusetts and Colorado, laws mandate that ministries disclose their enrollment and financial data to state insurance departments. However, incidents of fraud and misrepresentation have also been reported, with ministries facing legal challenges for failing to cover promised services. Berry's own experience, as she transitioned back to a traditional health insurance plan in January 2022, reinforced her belief that health shares can often be misleading.

“The way they marketed it was this is an alternative to insurance, and so it seemed like it was just a different way to get the same kind of coverage—and obviously that’s not true,” Berry stated. Her transition to traditional health insurance brought more straightforward claims processes, contrasting sharply with her previous experience of navigating the complex world of health care sharing.

As more families like Berry’s search for affordable health care solutions amidst rising costs and decreasing subsidies, the complexities of health care sharing ministries will remain a critical issue in the national health care debate. Their growing popularity raises important questions about consumer protection, access to comprehensive care, and the broader implications for public health in America.