Clyde Durham is a Nampa man - "61 years young," he says - who co-owns a landscaping company. He left a job several years ago that prompted him to go shopping for his own health insurance.
He never did buy it, though. A friend who administers a local church told him about a different option: health ministries, in which members pool money to pay each other's major medical bills.
Durham became one of the growing number of people choosing these ministries over traditional health coverage.
Durham chose Medi-Share, run by Christian Care Ministry. He pays about $360 a month for a membership, with a $1,250 deductible. The ministry has covered two knee surgeries, a gall bladder surgery and a mini-stroke, in which a nerve in his left eye "went wacko," he said.
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IT'S NOT INSURANCE
The Idaho Legislature and Idaho Supreme Court drew a clear line between health sharing ministries and insurance companies this year.
The Supreme Court in February overturned a 2011 decision by the Idaho Department of Insurance that a national ministry, Altrua HealthShare, was selling health insurance and must comply with all the rules governing insurers. The Legislature and Gov. Butch Otter put that distinction into state statutes, defining sharing ministries as exempt from rules for insurers.
The bill's sponsor, Sen. Sheryl Nuxoll, a Republican from Cottonwood, said in an interview that ministries are "something I think really should be there from the very beginning. We should be helping each other as neighbors, and this is an organized way to do it."
Though Nuxoll is not a member, she said her family is "very interested" and might join one.
DIFFERENCE IN THE DETAILS
When the federal mandate in President Barack Obama's Affordable Care Act to have health insurance kicks in next year, ministry members will have a special exemption and won't face tax penalties.
They also won't be guaranteed the same benefits, such as free mammograms and income-based premium credits, that will accompany traditional insurance plans.
Medi-Share and other programs don't cover "unbiblical" choices. For example, Medi-Share won't cover maternity costs for newborns conceived out of wedlock, except in cases of "verifiable rape reported to a law enforcement authority."
The programs require members to be Christian, sometimes interviewing church leaders to verify that claim. They don't admit members who smoke, get drunk, use drugs or have sex outside of marriage.
They also aren't regulated like health insurance and don't guarantee that medical bills will be paid, and that's where faith in fellow Christians comes in.
But they do resemble insurance in some ways:
- The organizations have deals with more than 500,000 health care providers nationwide to give members discounts. Medi-Share's average discount is about 26 percent, said Tony Meggs, president and CEO of Christian Care Ministry.
- They offer tiered memberships with different out-of-pocket and bill-sharing limits; in some cases, they use age and health to determine a member's payment.
Meggs said Medi-Share's overhead costs this year are about 11 percent of its revenues, well below the 20 percent threshold set for health insurers by the Affordable Care Act.
The program has about 19,800 member households nationwide; Meggs isn't sure how many are in Idaho. State lawmakers have estimated about 800 Idaho families or individuals are enrolled.
"The sharing ministries appeal to faith-oriented people," Meggs said. He said there is "definitely a correlation with people not wanting to rely on the government and wanting to participate in a faith-based sharing program."
CHEAPER FOR SOME
Meggs said Medi-Share member prices rise with each birthday. But the program overall had its last major increase - 10 percent or 11 percent - five years ago.
Local members say the math works in favor of ministries.
Nampa resident Beverly Donnell and her husband, Bruce, joined on a referral from Durham. They're healthy, but their monthly insurance premiums "kept going up and up and up," she said. They saw Medi-Share as a catastrophic option, with an out-of-pocket limit that was less than half of that required by their health insurer at the time.
They've had no bills covered by Medi-Share in the entire 2› years they've been members, Donnell said. But the money they're saving on monthly contributions covers the cost of preventive-care visits, she said.
She also likes being able to chip in an extra $1.50 or so with her usual monthly payment, in case other members need extra help.
Durham's medical bills have easily passed the $50,000 mark since he joined. The knee surgeries were $18,000 to $24,000 each, based on his memory of them, and the gall bladder operation was more expensive than those.
So even though Medi-Share doesn't pay for his annual eye exam and twice-a-year dental cleaning, he still came out way ahead. "It's very practical, because it works," Durham said.
As for the strict rules that Medi-Share holds its members to, "I had a mare, and she'd do anything for you, but you had to do it her way," he said. "It's the same way with Medi-Share."
Audrey Dutton: 377-6448, Twitter: @IDS_Audrey