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As Congress debates whether to mandate health insurance for all Americans, several Christian ministries whose members share each other's medical costs are hoping the final version of health care reform doesn't put them out of business.

Officials of three major "health sharing" organizations say they are watching the Capitol Hill discussions closely, and suggesting legislative language to ensure they qualify if Congress requires a "mandate" that all Americans carry health insurance.

"We don't just want to be left out in the cold," said Robert Baldwin, president of Florida-based Christian Care Ministry, which offers a "Medi-Share" program to its members.

Generally speaking, members of health-sharing groups—all of whom are professing Christians—pay a monthly fee that can range from $285 to $450 a month for a two-parent family. That fee is either sent to the ministry, which in turn passes it on to other members with certain medical bills, or sent directly to members in need.

It's an unorthodox way to pay medical expenses—and insurance regulators remain leery—but members say it's simply the latest incarnation of a 2,000-year tradition of believers carrying the burdens of other believers.

Baldwin is working with another organization, Illinois-based Samaritan Ministries, in the Alliance of Health Care Sharing Ministries to inform legislators about the more than 100,000 members of organizations who have chosen their alternative to health insurance.

"We are actively trying to get language inserted into any bill that would have health care sharing ministries considered quality coverage under a mandate," said Joel Noble, public policy team leader for both the alliance and Samaritan Ministries.

He pointed to ...

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