By Guy Page

As Vermont’s health care insurance rates climbed higher than neighboring states, the Vermont Legislature this year tried to crack down on what some Vermonters of faith consider a more preferable, more cost-effective alternative: the health care sharing ministry (HCSM).

Some health insurance plans cost three times as much in Vermont as comparable plans in New Hampshire, raising concerns about affordability and competitiveness. Vermont’s skyrocketing health care insurance rates have become a 2026 campaign issue. The Democrat legislative majority derided Gov. Phil Scott’s veto of a ‘referenced based pricing’ bill they say would have reduced insurance rates, which Scott says is only partly true, saying it would have reduced costs for some Vermonters (notably public unions) at the expense of others. For his part, Scott this month issued an executive order slightly relaxing the community rating that guarantees the same insurance rates regardless of age and health. 

HCSMs portray themselves as a glass-half-full alternative to health insurance: lower costs, people helping people. But some House and Senate Democrats see the glass half empty: unregulated, unreliable, and needing oversight.

H.585, a bill that passed the House this year but stalled in the Senate, would have required all health care sharing ministries operating in Vermont to submit highly detailed reporting about the people and finances of all health care sharing ministries, fining them $5000/day if they don’t. It also directs the Department of Financial Regulation to ‘prepare a report summarizing the information’ by the end of next year. 

Here’s how the HCSM’s work, according to an umbrella organization, the Alliance of Health Care Sharing Ministries: 

“Health Care Sharing Ministries allow faith-centered people to come together as a community to share each other’s medical expenses. Every month, members contribute a set amount that is shared between the other members to pay their medical bills. Each ministry does this differently, some have an online sharing technology system to approve the sharing of funds, others send individual checks to members. When members go to the doctor, hospital, or incur a medical cost, they submit the bill to their community, through their ministry. Expenses that meet the ministry’s guidelines are shared by the community and payment is made to the family or directly to the doctor.”

In January 2025, Progressive Democrats in the Vermont Legislature targeted health care sharing ministries with restrictive legislation with H102, introduced by  Representative Conor Casey (D-Montpelier) and Senator Becca White (D-Windsor). 

“These unregulated entities market themselves as alternatives to health insurance, often cloaked in religious language to avoid scrutiny,” said Casey in a press release. “Time and again, people are left holding the bag when they need care the most – paying into these plans only to find out there’s no guarantee of coverage. This bill is about transparency and consumer protection.”

Sen. Becca White (D-Windsor), lead sponsor of the Senate bill, added, “Vermonters deserve to know what they’re buying when it comes to their health care. Too many of these plans have left people vulnerable in their most difficult moments. Our bill ensures people get the information they need – and the accountability they deserve.”

The legislators say the bill would have protected consumers from “misleading and inadequate coverage.” 

VDC reported on H102 in April 2025. 

This bill went nowhere in the House Health Care Committee but – as often happens in Montpelier – key elements of a dead bill are often lifted and inserted into an omnibus bill that is far more likely to pass. That’s what happened this spring: rather than let it rise or fall on its own merits, key language in H.102 was quietly and quickly added as Section 10 in a healthcare insurance omnibus bill, H.585. this session.  The entire bill died in the Senate, possibly in response to efforts by the national Alliance of Health Care Sharing Ministries to draw attention to its anti-HCSM restrictions. 

The AHCSM said section 10 of H.585 targeted ministries without need. The proposed legislation was introduced without documented consumer complaints or demonstrated regulatory gaps. 

And it pointed out that it’s hardly the regulatory Wild West out there. Existing oversight already includes IRS nonprofit regulation, State attorney general authority, consumer protection laws, and independent accreditation boards

AHCSM also raised constitutional concerns. “Like Colorado’s law, which is being litigated at the Tenth Circuit Court of Appeals, Section 10 of Vermont’s H. 585 tries to force health care sharing ministries into the mold of an insurance entity, the very thing they are not intended to be.”

This also raises constitutional issues tied to the Establishment Clause, the Free Exercise Clause, Free Speech, and Freedom of Association, the group said. 

Furthermore, restricting health care insurance alternatives creates real cost risk for Vermont – driving health care sharing ministries from Vermont would reduce choices for all Vermonters. 

And it would enjoin Vermont to the lawsuit against Colorado, which has already spent thousands of taxpayers’ funds on attorneys, witnesses, and documents. 

“Vermont will likely face similar costs, with only a fraction of the population to bear this financial burden. Not a prudent use of your money,” the AHCSM said.

One thing, anyway, the AHCSM and its critics agree: health care sharing ministries are not health care insurance. 

“While they collect monthly fees from members, they operate outside state regulation and often deny claims, even for serious health diagnoses. Complaints about these ministries have been growing nationwide,” said the statement from Casey and White. 

White added, “Vermonters deserve to know what they’re buying when it comes to their health care. Too many of these plans have left people vulnerable in their most difficult moments. Our bill ensures people get the information they need – and the accountability they deserve.”

Backers of HCSM’s say the people who enroll know the risks, know they are not typical health insurance, but insist that health care decisions are a matter of personal choice, not state mandates.

Dan Treat, a Vermonter who has experience with HCSM’s, will be a guest on Chronicle Conversations at 12:20 PM today, Wednesday July 21, on WVMT AM-620, FM 101.3, and wvmtradio.com.