For nine years, as Obamacare tore through American households and clinics and hospitals, health-care sharing ministries quietly grew—twice, thrice, and now nine times their size.

Do Christians have a little edge on health care in the United States? Health-care sharing ministries (HCSM) are exploding—membership has increased 600 percent in nine years—as these unregulated oddballs maneuver freely in an industry that today is tethered by more rules and bureaucracy than ever before.

In the second Democratic presidential primary debate, Bernie Sanders and Kamala Harris raised their hands when asked, “Who here would abolish their private health insurance in favor of a government-run plan?” Wiping out our nation’s $600 billion private insurance industry would most likely include my family’s membership in a HCSM.

HCSMs: An Oasis Of Markets In a Sea of Socialism

HCSMs might just be the last stronghold through which a patient can energetically participate in market-oriented health care. Each year, thousands of Christian families like ours take the plunge, drop traditional health insurance, and join a sharing ministry. Like us, many find a surprisingly humane and affordable oasis outside of the cruel desert of Healthcare.gov.

HCSMs have been around since the late 1980s in smaller forms. When Obamacare threatened to end health-care sharing ministries in 2010, religious freedom advocates got loud, most notably lobbyist James Lansberry, who famously said, “Who is this Barack Obama who mocks the armies of the living God?” Senate Democrats caved, extending a tiny exemption from the Affordable Care Act to appease a mere 150,000 HCSM members.

For nine years, as Obamacare tore through American households and clinics and hospitals, HCSMs quietly grew—twice, thrice, and now nine times their size. Today there are 1.2 million HCSM members, and their medical expenses covered by sharing ministries exceeds $1 billion annually. Membership is expected to reach 1.68 million by 2020.

Growth has its pains, and some HCSMs are under fire over issues of quality and honesty. Member complaints within Trinity HealthShare and Aliera Healthcare Inc. have raised red flags in several states, especially Washington state, where both were ordered in May to stop operating.

Voluntary, Mutual Aid Has Its Risks

Joining a health-care sharing ministry is not without its risks and downsides. HCSMs are not insurance and cannot guarantee payment; this might be too off-the-grid by itself for many people. Most HCSMs have far less comprehensive “coverage” than traditional health insurance. Some, like Medi-Share, require members to never use any tobacco products and can cancel membership if it’s discovered that a member has smoked even one cigarette.

HCSMs typically aren’t set-it-and-forget-it as health insurance, whether it’s paying up front for prescriptions or medical care, sending in reimbursement forms, or realizing that preventative medicine even for children isn’t always shareable and finding cheaper options for vaccines, which can cost about $1,000 in each child’s first two years of life. Mental health care is not covered by any HCSM.

Still, for families like ours, membership in an HCSM has been a godsend. After one year of Obamacare hell, our family of seven scrapped our $1,100 (and rising) premium for a $465 monthly share through Medi-Share, the largest HCSM. When two of our children were hospitalized two months later, we held our breath, yet sure enough, thousands of dollars from fellow Medi-Share members poured in.

Medi-Share has a full-time staff of 594 and 400,000 members who pay an average of $405 a month. It’s the largest of an estimated 400 medical sharing ministries across the nation. One of its draws is its great customer service, modern technology, and member cards with “billing” information so doctor’s offices and hospitals can quickly get the information they need in a conventional way.

Diversity Within Sharing Ministries

But not everyone wants conventional. Samaritan International Ministry is the rogue of the biggest HCSMs, and arguably the most free-market, off-the-grid, and empowering. Samaritan has 80,000 members and no provider network. Members access a health care blue book for real-time health care pricing, an app to request bids for a procedure from doctors around the country, and training in negotiating up-front cash prices from any licensed professional in the world.

“If a member has cancer and wants to fly to Mexico and treat it nutritionally, great,” Samaritan spokesman Anthony Hopp told me in May. “What’s unbelievable to me is most of our health care currently involves third parties who know very little about patients and their needs, who have little medical training, and yet exert an inordinate amount of influence on a patient’s care.”

Samaritan members trade penalties, co-pays, insurance deductibles, subsidies, phone calls with billing reps, and medical bills for independence, control, and a community cheering them on through prayers, cards, letters, and checks. When a member suffered a miscarriage, she received reimbursement and sympathy. “One-anothering” is Samaritan’s purpose, Hopp said.

“We are soul, we are spirit,” he said. “And we emphasize the totality of a medical need; it’s not just a financial transaction.”

Samaritan finds equipping members to direct their own health care creates smart consumers. One Samaritan member, a self-employed electrical engineer, negotiated an average of 35 percent discounts on $200,000 in bills for her husband’s glioblastoma treatment. They received 277 checks from fellow members and almost every single one included a note of encouragement and prayer.

Can We Solve Health Care Without Government?

No other country comes close to our nation’s health care spending: the United States outpaces every country on private spending on health care—more than $10,000 a person in 2018—which is triple that of the second-place country. And there’s the $9.3 billion the eight largest publicly traded health insurers posted as net income in the first quarter of 2019, or the health insurance market’s projected worth of $1.5 trillion by 2026.

Adam Barsouk notes that “the majority of our health-care spending goes toward only 5 percent of the population, most of whom suffer from preventable chronic illnesses. When President Obama eliminated surcharges for pre-existing conditions, people lost their financial reward for living healthily. ”

The Congressional Budget Office estimates 7 million more people will be without health insurance in 2021, for a total of 32 million people under age 65. Also, it’s projected that the 36 percent of the American workforce who are self-employed will rise above 50 percent in the coming years.

So far, President Donald Trump is HCSM-friendly. His January 24 executive order included ordering the Treasury to propose new regulations to treat health-care sharing ministries as eligible medical expenses to be paid by health savings accounts, a radical tax advantage if pursued. Will more Christian Americans find freedom in HCSMs? I think so, right up until they’re regulated out.

Correction: An earlier version of this article incorrectly stated that Liberty HealthShare was ordered to stop operating in Washington state. That was in fact Trinity HealthShare.