North Texas Christians are turning to a faith-based alternative to pay for medical expenses while avoiding Affordable Care Act penalties for having no insurance.

With the midnight Friday deadline for ACA enrollment approaching, Christians are signing up for “health care ministries” like Medi-Share. Lower fees than insurance, a biblical community and exemption from the ACA are among aspects attracting them to the health care cost-sharing program.

But Medi-Share doesn’t share costs for pre-existing conditions, birth control, abortion, Viagra or long-term medication. Clients must also sign a statement of Christian faith.

They have to meet other conditions: be tobacco free, refrain from abusing alcohol and prescription drugs, and say no to illegal drugs.

“The cost of health insurance is so expensive that those people that are healthy are looking at this,” Wichita Falls insurance agent Kelly Fristoe said.

He tells his clients to closely read the 50-page booklet Medi-Share has posted online before signing up.

Fristoe said insurance premiums shot up 60 percent for 2017 and 30 percent for 2018.

He came on board with Medi-Share about three years ago after noticing he was losing clients to it, said Fristoe, a regional vice president for the National Association of Health Underwriters. This year, perhaps 20 percent of his approximately 1,000 clients have signed on with Medi-Share.

They tend to be upper-income people who don’t have access to employer-based coverage or qualify for ACA subsidies.

Texas has more people in Medi-Share – 52,636 – than any other state, said Michael Gardner, director of communications at Christian Care Ministry, which operates Medi-Share.

In total, 326,365 people are in Medi-Share, Gardner said.

“We’ve seen growth certainly since the administration of the Affordable Care Act,” Gardner said.

Medi-Share isn’t new. It’s been around since 1993, Gardner said.

The Christian tenants it’s based on aren’t new, either.

“We really look to the early Christians for our motivation and inspiration of taking care of each other,” Gardner said. “This idea of sharing goes back thousands of years.”

The way the program works is an individual or a family pays a flat fee based on the oldest person in the household, Fristoe said. The membership fee helps others pay eligible medical expenses.

For instance, a family of four with a 42-year-old as the oldest person can pay a middle-of-the-road cost of $439 a month. They will have to meet a $5,000 annual household portion before cost sharing begins.

Then Medi-Share foots the bill for 100 percent of the remainder of eligible medical expenses. The annual household portion has to be met somewhat in the same way a deductible does in health insurance.

In another example, a 42-year-old individual pays $218 to be a Medi-Share member and has an annual household portion of $5,000, too.

Gardner said the average family pays about $350 a month.

Medi-Share members are able to see who their monthly fees have helped under conditions that leave confidential medical information protected, he said. The cost-sharing program also streamlines the process of paying for care.

Members have access to a national network of physicians and pre-negotiated rates, Gardner said.

Fristoe said North Texas physicians tend to treat Medi-Share members as cash patients. Cash rates are generally lower. The patient pays up front, and then turns to Medi-Share for cost sharing.

During the shortest enrollment period for ACA yet, agents and certified application counselors have had to scramble to sign clients up.

The first year of ACA open enrollment, signup lasted about six months, Fristoe said. The second year featured a three-month open-enrollment window with some extensions.

Yet more people are signing up during this year’s 45-day open enrollment period, said David Preston, director of marketing and outreach for the Community Healthcare Center in Wichita Falls.

For the 2016 open enrollment, the CHC enrolled 359 people and assisted about 1,100 people, Preston said.

With one more day to go, the CHC enrolled more than 400 and assisted about 950.

Read more at Christians snub Obamacare for faith-based health plan.