An informal May survey by the National Association of Evangelicals (NAE) confirmed what many pastors and denominational leaders have long known: many churches offer inadequate health care to their shepherds.

The majority of denominations that responded to the survey offered little or no health insurance to pastors or other fulltime church staff.

"It's really a crisis," NAE president Leith Anderson said. "If things stay as they are, there is going to be a significant loss of pastors from the ministry."

Many denominations, like the Evangelical Free Church of America (EFCA), formerly offered health insurance benefits to their pastors, but ceased when insurance costs increased. According to the Kaiser Family Foundation, health premiums increased 78 percent between 2001 and 2007.

"We had to close our plan eight years ago," said John Herman, executive director of pastoral care ministries for the EFCA. "It is hard, because unless you have forced participation, you experience adverse selection."

The term "adverse selection" refers to potential program beneficiaries — often young, healthy pastors — who choose to find less expensive health insurance on their own. When they opt out of a denomination's plan, the denomination is left with a pool of pastors who are older or ill. This causes rates to rise, which in turn prompts more pastors to seek cheaper rates elsewhere.

The rates for the small pool that is left eventually become so high that a denomination cannot afford to keep its program going, Herman said. Denominations that require pastors' participation may have a large enough group to keep rates down, he said, but many loosely affiliated denominations cannot require such involvement.

"The inability of local churches to provide ...

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