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RENEE MONTAGNE, host:

Here's another twist on the high cost of health care. Several evangelical Christian groups have found a way of getting around that high cost of health insurance. Instead of paying premiums, they simply agree to pay each other's medical bills. And members take, on faith, the promise that others will help them. NPR's Jeff Brady reports.

JEFF BRADY: Samaritan Ministries' vice president, James Lansberry, is constantly on the radio and traveling around, talking about his organization these days. Here he is at a church outside Denver.

Mr. JAMES LANSBERRY (Vice president, Samaritan Ministries): And if youre like most Americans, you have some form of health insurance. If youre like a few of us, who are part of Samaritan Ministries, you have something that's better than health insurance.

BRADY: There's an annual fee that covers Samaritan's administrative costs. Lansberry says the nonprofit group compiles members' health care bills, then tells its 14,000 households where to send their monthly checks.

Mr. LANSBERRY: The money doesn't get received at our central office it goes directly from one family to another. So each month I send my monthly share of $285 directly to another family.

BRADY: Two hundred eighty-five dollars a month is all it costs for Lansberry's entire family, he and his wife and seven children. That's a fraction of what a typical health insurance policy would cost.

Out in the church lobby, Carl Bobb says he's been using Samaritan for six years. He says getting his medical bills paid is relatively easy.

Mr. CARL BOBB: When we have, you know, a payment due on something, we'll pay what the minimum is if they'd like us to pay that day. We submit it to Samaritans. And within 30 days we get our claims processed through Samaritans and checks start coming in from folks.

BRADY: Bobb says often there's a not included with the check, offering encouragement and prayers.

Nearby, Chris and Mary Miller from Oakland, Illinois, just emerged from the Samaritan Ministries' presentation. They're self-employed farmers and now they're thinking about giving up their current health insurance.

Mr. CHRIS MILLER (Farmer): Because we spend around $15,000 a year on health care premiums.

BRADY: In addition to saving money, Mary Miller says she likes that Samaritan promises that no money will ever be used to pay for an abortion. And she says she's not worried about giving up the security of traditional insurance.

Ms. MARY MILLER (Farmer): Being a Christian means walking by faith. And we believe that God is ultimately in control of everything, and that things work best when you go his way.

BRADY: Religion is a huge part of Samaritan's business model. Members need a pastor's signature just to join. And there are restrictions. For example, if a member contracts a sexually transmitted disease outside of a marriage, Samaritan members won't pay the associated health care costs.

For the group's main program, benefits are capped at $100,000. If costs start to outpace the amount of money coming in, members vote to raise their monthly contributions. Underneath everything, including the lack of government regulation is a warning: Samaritan and other groups like it never guarantee an individual's bills will be covered.

Pennsylvania Insurance Commissioner, Joel Ario, says that's something people should carefully consider before signing up.

Mr. JOEL ARIO (Pennsylvania Insurance Commissioner): Because the insurance product is a legal obligation of the insurance company, that will be there, even if the claims you have turn out to be very large in nature

BRADY: In coming days, groups like Samaritan Ministries are keeping a close watch on health care legislation in Congress. The big question is whether they'll win an exemption from health insurance mandates for their members, because if their members are forced to buy insurance anyway, there's little reason to contribute to Samaritan's insurance alternative, too.

Currently, the Senate-passed bill includes the exemption. The House-passed bill does not.

Jeff Brady, NPR News.

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