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When people first hear about health sharing, they wonder how they could use a Health Share as an alternative to Health Insurance—and how that would work with the Federal Health Care Law.
Are You Required to Have Health Insurance?
Since 2019, you are no longer required to obtain Minimum Essential Coverage (MEC) under the Affordable Care Act, and there is no federal penalty for not having traditional health insurance.
For most Americans, this means you can simply join a health share and use that as an alternative to health insurance.
States With Their Own Health Insurance Mandates
Even though the federal mandate is gone, some states have their own requirements. Currently, the states (and one district) with individual mandates are:
- California
- District of Columbia (Washington D.C.)
- Massachusetts
- New Jersey
- Rhode Island
- Vermont
These states require residents to maintain health insurance that meets MEC standards, though Vermont does not currently impose a financial penalty for not having MEC.
Find Out Your State’s Rules
State mandates and penalties can change over time. To see the latest MEC requirements, penalties, and any restrictions for health share members in your state, check out our Interactive Map of State Rules for Health Shares.
How Health Shares and State Mandates Work Together
If you live in a state with an individual health insurance mandate, it’s important to understand that a health share is not considered Minimum Essential Coverage (MEC). This means:
- Joining a health share alone will NOT meet your state’s requirement.
- You could face state tax penalties if you do not also have a MEC-compliant plan.
What you can do instead:
- Keep or purchase a MEC-Compliant Health Insurance Plan – This satisfies your state’s legal requirements and avoids penalties.
- Add a Health Share for Larger Medical Needs – Many people in mandate states keep a lower-cost MEC plan for compliance and routine care, while using a health share for bigger expenses like hospitalizations, surgeries, or other high-cost medical events.
This approach lets you meet state requirements while still benefiting from the lower costs and flexibility a health share can provide.
Why Some People Choose a Health Share Over Insurance
Even in states without mandates, many people choose health shares because:
- Lower Monthly Costs – Contributions are often significantly less than insurance premiums.
- Freedom to Choose Providers – Many health shares allow members to see any doctor or specialist.
- Community-Based Support – Members’ contributions directly help pay other members’ eligible medical bills.
Next Steps
If you’re considering joining a health share, it’s important to compare your options carefully. For a side-by-side look at some of the most popular choices, check out my guide to the Best Health Share Plans.
Health shares are not insurance and do not offer insurance coverage. Membership in a health share does not guarantee the payment or reimbursement of medical expenses. Each organization operates under its own membership guidelines, which determine what expenses may be eligible for sharing. This publication is for informational purposes only and is not provided by an insurance company. For state-specific notices and full program details, please visit the respective health share’s official website.
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