The idea behind the Affordable Care Act was pretty simple: Too many people were uninsured, and when they couldn’t pay their health care bills, the cost fell on the taxpayer. So, the government tried to insure more people through state insurance exchanges. To encourage people to join, the government instituted a penalty for those who didn’t pay for health insurance.That works OK for most states. But not Alaska.The cost of health care is dramatically higher there, and there are more very sick people per capita than in any other state. Treating those sick people is costly, and there aren’t enough healthy, cheap people to balance them out on the insurance exchange.Laura Oates Butcher and her husband, Clay, priced out their coverage on the Alaska insurance exchange. The bill: $30,000 a year for their family of four. And a $15,000 deductible. That’s a total of $45,000 gone before they could even start getting coverage.That’s where Christian health share ministries come in. It's a system involving Christians supporting other Christians with money for their bills. The number of people on health shares has skyrocketed from fewer than 100,000 before the ACA to well over 1 million today — including Laura's family.The health shares negotiate with doctors and hospitals, like an insurance company, and the health shares are supposed to cover out-of-pocket expenses.But health shares are not insurance. They were granted an exemption in the Affordable Care Act so members who use them don’t have to pay an ACA penalty. They come with some strings: Members have to adhere to a moral code; there’s no coverage for abortion or birth control; the health shares have a per-incident coverage cap of $1 million.And most important: Unlike insurance, health share ministries make no promises to pay.
This segment originally aired March 23, 2018, on VICE News Tonight on HBO.
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