A Texas couple expecting their third child turned to Obamacare earlier this year, thinking it was the answer to their lack of insurance. Instead, they were frustrated when they couldn’t find a doctor who suited their needs and ended up turning to an alternative method of paying for medical expenses that’s been gaining interest since the Affordable Care Act went into effect.
Rachel Robinson, who lives in Dallas with her husband and children, flipped from wanting an insurance-paid hospital delivery to a home delivery with a midwife, paid for through a medical cost-sharing program.
Robinson remembered when she initially wrote off a friend who had suggested a home birth after Robinson voiced that she was having a hard time finding a doctor and hospital to accept her Blue Cross Blue Shield insurance purchased through Obamacare.
“I wasn’t quite ready to hear all the no’s I was hearing,” Robinson told TheBlaze. Starting down the list of insurance-approved doctors, “they would say things like, ‘Well we have to pay these high premiums so we can’t always take the Obamacare patients. … It was all very vague. Some would come out and say, ‘We just don’t take Obamacare even though we’re on the list.’ It was very weird.”
After two days of calling and not finding a doctor that would accept her insurance or be in an area where she was willing to travel, Robinson and her husband wondered: “Why am I paying all this money a month for basically nothing?”
Dropping Obamacare and Daring to Share
That’s when the Robinsons dropped their insurance plan, selected a midwife and prepared for a medication-less home birth that was just a few weeks away.
Looking back, Robinson said she wouldn’t change it: not only her home birth, but the choice they made to join the cost-sharing program, Samaritan Ministries.
“We love it so much because we don’t go to the doctor that often. With the sharing program, you only have to pay up to $300 for regular visits,” Robinson explained.
The Robinsons pay $375 every month for the program. If a medical bill exceeds the $300 cap that they would pay at the doctor’s office, that’s when the cost-sharing component comes into play.
Anthony Hopp, Samaritan Ministries’ director of membership development, told TheBlaze that if someone had a $100,000 medical bill, there would first be a strict process to vet the medical need and accuracy of the billing. After that, the organization allocates various members to send their monthly checks directly to the recipient, making sure the right amount gets to that person to pay off their bills. The recipient knows who is supposed to be supporting them with their monthly membership fees (the Robinsons, for example, send their $375 check to a specific person) and keeps a log of who they’ve received money from to report back to the organization as well.
Hopp said that there has “certainly been an uptick” of a least interest, if not membership, in Samaritan Ministries after Obamacare’s changes to the health system went into effect. But he said it’s not the only driver.
Hopp called it a “perfect storm.”
Cost-sharing programs use to be “somewhat of a new concept, but I think the fact that it has been established for 20 years, it has taken people a while to see it as a viable option.”
Samaritan Ministries has about 35,000 households or families representing about 115,000 individuals, and Hopp said they’ve seen their net growth hover around 18 to 24 percent in the last few years. Hopp said Samaritan Ministries is one of three Christian-oriented cost-sharing programs.
Liberty HealthShare, while based on a religious tradition, more loosely adheres to a set of shared beliefs that it asks its members to have without specifying religion.
“We are just simply making ourselves available to like-minded Americans so long as they agree with our shared beliefs. Whereas the other groups do require you be active Christian, we just simply say, ‘Here’s our set of shared beliefs,'” Liberty HealthShare Executive Director Dale Bellis said.
Bellis said he believes Obamacare has been a driver in such cost-sharing programs.
“The Affordable Care Act obviously has raised awareness regarding health costs but also options and opportunities for ways to do so on a grassroots level. That’s really what Liberty HealthShare represents,” Bellis said.
‘The Financial Part Is Just the Tip of the Iceberg’
Hopp said it’s not just religious or political factors that have people turning to a cost-sharing program either.
“More and more people are questioning where their health care dollars are being sent,” he said. “There’s no way to know.”
With Samaritan Health Ministries, members know exactly where their money is going, because they write a check to a specific person each month. For some people, he thinks, this personal support aspect is attractive for sharing programs.
“I’m writing a check directly to another Samaritan member, I feel good about that,” Hopp said. “The financial part is just tip of iceberg. The concept, the intent is to go much deeper than just financial need. Our members are sending cards, notes of encouragement. Community is what makes this whole thing spin.”
But Hopp pointed out that even if the demand of such cost-sharing programs increases as people seek options outside of traditional health care for whatever reason, new programs will not be started due to a provision preventing them in the Affordable Care Act.
Cost-sharing programs, like Samaritan Ministries and Liberty HealthShare, were an exemption because they were in operation before Dec. 31, 1999. Bellis speculated that keeping cost-sharing programs “as limited as possible … would seem to be the motivation” of the government setting this date.
As for the Robinsons, they plan to stick with Samaritan Ministries for now and hope to continue in the future, even if her husband’s job takes them elsewhere where traditional insurance options are available.
“We really want to talk to his next employer, want to talk about insurance, because we want to stay on cost-sharing. We like to know where our money is,” Robinson said.
Front page image via Gil C/Shutterstock
This story has been updated to correct Samaritan Ministries name and to add clarification.