The front page of Samaritan Ministries’ website touts a reliable, Christian way to cover healthcare costs; a “… Biblical, non-insurance approach to health care,” if you will. Users are given the impression that like health insurers, organizations like Samaritan will cover their basic healthcare costs; such as primary care, childbirth, prescription medicines, or emergency care. Upon first glance, the list of plans of different tiers with monthly prices listed against a backdrop of pastels make the website seem no different than any other health insurance company’s website. It bears a striking resemblance to websites for companies such as Aetna or United Healthcare. What this carefully curated image won’t reveal is a growing string of lawsuits, unpaid bills, and heartache.
Health Care Sharing Ministries (HCSMs) are defined as, “…a form of health coverage in which members, who typically share a religious belief, make monthly payments to cover expenses of other members.” An August 2018 report from the Commonwealth Fund revealed that HCSMs do not include basic protections under the Affordable Care Act. These organizations do not offer coverage for pre-existing conditions, can charge higher rates based on health status, and may exclude essential health benefits. They may also decline to cover benefits without dollar caps on health care services, or fail to cap out-of-pocket costs to members.
The lack of monitoring of HSCM activities has been drawing increasing attention from regulators and lawmakers. Most notably in 2024, the co-founders of Missouri-based Medical Cost Sharing, another HCSM, plead guilty to an $8 million wire fraud conspiracy in the Western District of Missouri. James McGinnis and Craig Anthony Reynolds collected $8 million in revenue and used only 3.1% of this amount to pay health care claims. Similarly, in 2023, an Atlanta-based health care sharing ministry called Trinity run by a company called Aliera declared bankruptcy, leaving behind $660 million in unpaid medical claims. Aliera is suing former CEO Shelley Steele for loans she received from the company and never repaid, including one loan of over $6 million. Liberty HealthShare, based out of Ohio, used $140 million of the $300 million they received in member fees to fund a boutique airline, a marijuana farm, buy real estate, and carpet stores; all while their health sharing subsidiaries Cost Sharing Solutions and Medical Cost Solutions LLC went bankrupt.
In response to the ongoing cases of fraud and lack of regulations, states like Oregon and Washington State are stepping up to protect consumers from incurring crippling debt and hardship. Oregon Democrats introduced HB 2268 in 2025 which would require any individual or organization marketing or selling a health care cost sharing arrangement to register with the Oregon Director of the Department of Consumer and Business Services. The office of Washington State Insurance Commissioner (OIC) Patty Kuderer fined ClearShare Health $275,000 in 2025 for selling insurance plans, disguised as “memberships,” without permission from the OIC and using only $54,201 of the $524,095 they collected in fees between 2022 and 2024 to pay their members’ medical expenses.
Unfortunately, with the extreme cost of healthcare, severe cuts to Medicare and Medicaid, and a myriad of misinformation, consumers may continue turning to health care sharing ministries to help cover the cost of healthcare. In spite of the widespread documented cases of fraud, both the previous and current Trump Administrations have shown support for healthcare sharing ministries. The current Trump Administration plans to ensure tax parity for healthcare sharing ministries as part of their larger plan to lower healthcare costs by deregulating the health insurance industry, Medicare, Medicaid, and other federal programs. These changes would impact more than 1.5 million Americans who are members of a health care sharing ministry.
Consumers looking to save on health insurance or who do not believe that health insurance or federal programs align with their values, should think twice before purchasing a membership from a health care sharing ministry. With the federal government’s support of health care sharing ministries, it is up to state regulators to protect consumers. Increasing supervision of healthcare sharing ministries and imposing long overdue penalties on those engaged in fraudulent practices is long overdue. For an industry that has promised those in need so much, they have left thousands with even more debt, grief, and regret than before.