The Kentucky Supreme Court ruled last week that Medi-Share, a self-described "non-insurance healthcare program based on biblical principles" is indeed a health plan.
Medi-Share, founded in 1993 and based in Melbourne, FL is operated by the non-profit Christian Care Ministry. Medi-Share describes itself as "a program where Christians share each other's medical expenses. Christian Care Ministry and the Medi-Share program are not registered or licensed by any insurance entity, nor are they required to be. CCM does not collect premiums, make promise of payment, or guarantee that your medical bills will be paid. Sharing of medical bills is completely voluntary."
Kentucky sees it differently. "The Medi-Share program "fits comfortably within the statutory definition of an insurance contract because it shifts the risk of payments for medical expenses from the individual to a pool of people paying into the program. Thus, regardless of how Medi-Share defines itself or what disclaimers it includes in its literature, in the final analysis, there is a shifting of risk," Justice Daniel J. Venters wrote for the court. The 5-2 decision is here.
I expect we'll be seeing more of these faith-based alternatives to health insurance as the 2014 deadline for near-universal health coverage nears. The Patient Protection and Affordable Care Act specifically exempts healthcare sharing ministries from the requirement. And that's where things get fuzzy, because it's hard to tell them apart from licensed health plans.