To amend sections 1716.01 and 5747.01 and to enact sections 1716.22 and 3333.96 of the Revised Code to enact the Health Care Sharing Ministries Freedom to Share Act.
Summary
HB21 creates the “Health Care Sharing Ministries Freedom to Share Act” and makes a series of statutory changes to recognize health care sharing ministries under Ohio law. The bill defines a health care sharing ministry as a nonprofit organization whose participants share common ethical or religious beliefs and who voluntarily contribute to one another’s medical or financial needs. It requires these ministries to provide annual independent audits, annual sharing reports, and a written disclaimer stating that the organization is not insurance and that participation does not create an insurance policy or guarantee payment of medical bills.
The bill also amends Ohio’s charitable solicitation law to incorporate the new definition and adds a new section stating that a health care sharing ministry is not engaged in the business of insurance and is not subject to Ohio insurance laws. It gives the attorney general exclusive authority to determine whether an organization qualifies as a health care sharing ministry and preserves constitutional and common-law protections for religious organizations and individuals. In addition, the bill requires state institutions of higher education that mandate student health coverage to accept participation in a health care sharing ministry as satisfying that requirement.
On the tax side, HB21 amends Ohio’s income tax code to allow taxpayers to deduct amounts paid for membership in a health care sharing ministry for themselves, spouses, and dependents. This would reduce Ohio taxable income for eligible taxpayers and effectively provide a state tax benefit for participation in these ministries. The bill applies the income tax change to taxable years ending on or after the effective date of the section.
The general sentiment reflected in the voting history appears favorable, though not unanimous. The bill received a 10-1 favorable passage vote in the House Insurance Committee and later passed the House 65-31, suggesting meaningful support for expanding legal recognition and tax treatment for health care sharing ministries. The absence of committee transcript discussion limits insight into detailed arguments, but the vote pattern indicates the measure was broadly supported by proponents while still drawing substantial opposition.
The main point of contention is likely the bill’s treatment of health care sharing ministries as an alternative to insurance. Supporters appear to favor religious liberty, consumer choice, and reduced regulatory burden, while opponents may be concerned that the bill blurs the line between insurance and non-insurance arrangements, potentially leaving participants without the protections that apply to regulated health insurance. The tax deduction and the requirement that colleges accept ministry participation as coverage are also likely to be debated because they extend public recognition to a non-insurance model.
Impact
HB21 would amend Ohio’s charitable organization and income tax statutes and create new provisions in the insurance and higher-education codes. It would exempt qualifying health care sharing ministries from state insurance regulation, authorize the attorney general to determine qualification, require disclosures and audits, and allow taxpayers to deduct ministry membership payments from Ohio adjusted gross income. It would also require state institutions of higher education that impose health coverage mandates to accept health care sharing ministry participation as satisfying those mandates, affecting students, ministries, insurers, and institutions of higher education.
Sentiment
The bill appears to have received generally favorable treatment in the House, with a strong committee vote and a clear floor majority, indicating support for the policy goals of religious freedom, consumer choice, and reduced regulation. At the same time, the 31-member opposition on the House floor shows that the proposal was not broadly consensus-driven and remained controversial. No committee transcripts were provided, so the recorded votes are the main indicator of sentiment.
Contention
The central contention is whether health care sharing ministries should be treated as a distinct, faith-based alternative to insurance or whether they should face insurance-like oversight because they function as medical cost-sharing arrangements. Supporters likely emphasize religious liberty and voluntary participation, while opponents may worry about consumer protection, the adequacy of disclosures, and the risk that participants misunderstand the lack of guaranteed coverage. The college coverage mandate and the new tax deduction are additional likely flashpoints because they extend legal and fiscal benefits to ministry participation.
To amend sections 3517.12, 3517.13, and 3517.155 of the Revised Code to modify the Campaign Finance Law regarding foreign nationals and statewide initiatives and referenda and to declare an emergency.
To amend sections 3505.01 and 3505.10 of the Revised Code to modify the deadline for a political party to certify its nominees for President and Vice-President to the Secretary of State.
To amend sections 3517.12, 3517.13, and 3517.155 of the Revised Code to modify the Campaign Finance Law regarding foreign nationals and statewide initiatives and referenda and to declare an emergency.
To delay the deadline for a major political party to certify its presidential and vice presidential candidates to the Secretary of State for the 2024 general election.