Freed from insurance: Health care sharing ministries and the moralization of health care

Since the Affordable Care Act (ACA) was passed in 2010, health care freedom has become a kind of mega-narrative trumpeted by Republicans leaders who decry government overreach. I turn to faith-based, non-profit organizations called “health care sharing ministries”(HCSMs) to consider the work that this mega-narrative does in everyday health care lives. While HCSMs are not insurance, HCSMs share in the payment of medical bills and are written into the ACA as one religious exemption to the individual mandate. Based on ethnographic interviewing done with 31 people in Maryland, Ohio, Virginia, and Pennsylvania between 2015 and 2020, I examine the ways that Americans who belong to HCSMs take up freedom as a guiding frame to reflect on and moralize their health care. I argue that articulations of freedom in HCSMs involve freedom from the constraints of bureaucratic care and governmental control and are tethered to a single, overarching moral discourse that presents freedom as the freedom of choice. I suggest, therefore, that being a part of an HCSM is about getting health care—including getting it cheap—but it is also about how the health care makes people feel as moral persons in the current political climate of U.S. life.