Despite President Donald Trump’s executive order to begin dismantling Obamacare, a record number of Americans signed up for marketplace plans during the 2017 enrollment period, which ended Tuesday.

Meanwhile, the number of Christians taking advantage of religious exemptions to the Affordable Care Act (ACA) also reached an all-time high. As of January, well over 625,000 believers belong to health care sharing ministries—more than triple as many as when the Obama administration enacted the legislative overhaul of the health insurance market in 2010.

Nashville videographer Matt Horvath joined Medi-Share last month, after leaving his employer’s plan when he started his own business. He and his wife settled on health care sharing—where fellow members pay a few hundred dollars a month to cover each other’s major medical bills—after they struggled to find major insurance carriers in their state that offered individual plans or affordable options through the ACA marketplace.

Horvath and other members of such ministries (provided the organizations have been functioning since before the year 2000) are exempt from the ACA’s individual mandate, which penalizes Americans without health insurance. Days after Trump took office, adviser Kellyanne Conway indicated that the President would not be enforcing the mandate any longer. The eventual end to the individual mandate will do away with the need for a religious exemption.

Between that announcement and Trump’s executive order urging agencies to ease ACA requirements, “it’s a pretty significant step,” said Anthony Hopp, spokesman for Samaritan Ministries. “Things are definitely in motion. But we anticipated that with Trump.”

Samaritan Ministries, Medi-Share, and Christian Healthcare Ministries are among the biggest heath care sharing groups, and they’ve watched their numbers climb under the ACA. When Hopp joined Samaritan in 1997, the organization served 1,000 households. By the time he spoke to CT in January, that number was up to 68,200—over 221,000 people total.

After a mostly unexpected boost over the past few years, these ministries are unsure how Trump will go about repealing and replacing Obamacare—particularly how his policies might impact the demand for insurance alternatives.

But given the satisfaction among their members—content to trust God and one another for their medical bills—they aren’t worried about Christians fleeing back to the insurance side. As insurance costs keep rising, the cost-sharing movement is actually looking at the new landscape as a chance to expand beyond individual plans to organizational and corporate setups.

“Health care sharing ministries existed before the ACA, God willing, they thrived during the ACA, and they will survive after,” Hopp said.

Health care sharing—inspired by the biblical call to “bear one another’s burdens” and the example of the Acts 2 church that “had everything in common”—has been around for decades. But these nonprofits are gaining prominence in today’s sharing economy, led by industry disrupters Uber and Airbnb.

What began as small-scale, relatively unknown operations in the late ’80s and early ’90s now flourish in a culture willing to rethink its relationship with institutions and each other. It doesn’t seem as strange to count on the generosity of neighbors now that crowdfunding is on the rise; hundreds of thousands of Americans have turned to online campaigns to cover unexpected medical costs on sites like YouCaring.

June
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