Robert Baldwin, president, left, and E. John Reinhold, chairman, run the Christian Care Ministry in Melbourne, Fla.
About Diana Henriques
This is the “medical bill sharing ministry” known as Christian Care Ministry, based in Melbourne, Fla., the largest of a handful of similar ministries around the country.
E. John Reinhold, who once worked with the Campus Crusade for Christ and is now the ministry’s chairman, explains the concept simply: “You add up all the medical bills and divide by the number of sharing households. Everybody kicks in and you pay the bills.”
Every month, in roughly 19,000 households across the country, ministry members — who must be observant Christians with recommendations from their pastors — write a check to Christian Care Ministry. The amount depends on their family’s size and how much of their medical bills they are willing to pay out of their own pocket.
And each month, the ministry writes checks to health care providers — totaling more than $240 million since it was founded — to cover the medical bills submitted by its members. Roughly $57 million moved through the ministry in its latest fiscal year.
Mr. Reinhold, who formed Christian Care in 1993, says it is an efficient way for Christians to fulfill the admonition of Galatians 6:2, which tells them to “carry each other’s burdens, and in this way you will fulfill the law of Christ.”
But over the years, some state officials have looked at ministries like Christian Care and seen what they would call unregulated health insurance. Their concern is that confused consumers looking for low-cost coverage will rely on these groups as if they were insurance companies, even though the groups may lack the resources to pay claims.
Next week it will be Mr. Reinhold’s turn to defend his organization, before a state judge in Kentucky.
Kentucky was one of a half-dozen states that passed laws in the early 1990’s exempting religious bill-sharing ministries from state insurance laws. But regulators there say that Mr. Reinhold’s organization goes beyond what that exemption allows — a claim the Florida ministry says is misguided, because its practices actually improve on the state’s requirements.
The exemption being tested in Kentucky this month is just one of a host of special arrangements for religious ministries that are not available to similar secular organizations — exemptions rooted in the First Amendment’s ban on any Congressional action that would restrict the free exercise of religion or establish an officially sponsored religion.
Special breaks like these have been accumulating at a time when religious organizations of all faiths are expanding into a range of new activities that may compete directly with businesses and other nonprofit organizations that are not eligible for the same exemptions.
The Internal Revenue Service has a number of special rules for religious nonprofit groups. Under those rules, as a ministry of the American Evangelistic Association, which ordains clergy and supports various educational and humanitarian missions, Christian Care Ministry is not required to file public financial statements with the I.R.S., as secular nonprofit organizations are.
The I.R.S. makes this exemption available to all churches — including synagogues, temples, mosques and other congregational forms in different faiths — as well as church associations, auxiliaries and retirement plans; religious elementary and secondary schools; foreign mission societies; and the “exclusively religious” activities of any religious order.
As part of a church association, Christian Care is also protected by special limits Congress has put on the I.R.S.’s ability to audit religious congregations.
These restrictions, which do not apply to other nonprofit groups or for-profit entities, require a top-level I.R.S. official’s approval before any audit can begin. The religious group must get advance notice and the opportunity for a personal conference before the audit can proceed. The audit must be finished in two years. Finally, if the inquiry does not turn up deficiencies, the I.R.S. cannot return to audit that issue again for five years.
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