Dylan Scott

Then the Affordable Care Act passed and was this big flashpoint politically, as people well know.

especially for like deeply conservative and religiously devout people they had a lot of objections to the ACA some of them had objections to like the provisions that required insurers to cover birth control things like that and so they were like you know what I want to like

opt out of this law.

Actually, the law and the way that it was written gave them an out.

It said that if you sign up for a healthcare cost-sharing ministry, if you're enrolled in something like that, then you can be exempted from the individual mandate.

I think all of those things combined together to start driving a lot more people to these healthcare cost-sharing ministries.

It sounds a lot almost like mutual aid.

Yeah, I think that's the crux of it, I think, in a lot of ways.

But increasingly, these are like sophisticated businesses with really well-funded advertising campaigns.

They've increasingly de-emphasized the religious aspect of it.

You see them adopting names like Liberty HealthShare and things like that.

Even with the moral and ethical standards that they want people to sign on to, they've more and more de-emphasized you have to believe in God and that Jesus Christ is our Lord and Savior.

It's more like you're going to be an upright person, you're going to be moral, but in a vaguer, more secular way.

And I think that's because these companies see a business opportunity.

How many people use these kinds of ministries?

Back in the day, in the mid-2000s, there were like 200,000 people enrolled in these plans.

As of about 2018, there were a million people enrolled in a cost-sharing.

A pretty significant increase from the decade before.

Then past that, as the most recent estimate that we have, and it's worth emphasizing, because these things are poorly regulated, it's hard to get really reliable data about them because these can just operate without the government even really knowing about it.

But the Colorado Department of Insurance tried again to estimate how many people have joined these ministries in 2023, and they came up with 1.7 million Americans were now enrolled in a healthcare cost-sharing ministry.