OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 474 Bill Analysis
135th General Assembly
Version: As Introduced
Primary Sponsors: Reps. King and Mathews
Effective date:
Nick Thomas, Research Analyst
SUMMARY
 Specifies that health care sharing ministries that meet certain qualifications are not
engaged in the business of insurance and not subject to the insurance laws of Ohio.
 Specifies that any requirement made by a state institution of higher education that
attending students have health care coverage is met by participation in a health care
sharing ministry.
 Authorizes a personal income tax deduction for dues paid for membership in a health
care sharing ministry.
 Names the bill the “Health Care Sharing Ministries Freedom to Share Act.”
DETAILED ANALYSIS
Overview
The bill specifies that health care sharing ministries are not engaged in the business of
insurance and therefore not subject to the insurance laws of Ohio.1 Generally speaking, a health
care sharing ministry is an organization that collects dues from members and then redistributes
a portion of the amounts collected to members who have incurred health care costs. The bill
specifically defines a health care sharing ministry as a nonprofit organization that does all of the
following:
 Limits its participants to those members who share a common set of ethical or religious
beliefs;
1 R.C. 1716.22(A).
June 11, 2024
Office of Research and Drafting LSC Legislative Budget Office
 Acts as a facilitator among participants who have financial or medical needs to assist in
meeting those financial and medical needs in accordance with criteria established by the
organization;
 Provides for the financial or medical needs of a participant through contributions from
other participants;
 Provides amounts that participants may contribute with no assumption of risk or
promise to pay by the health care sharing ministry to the participants;
 Conducts an annual audit which is performed by an independent certified public
accounting firm in accordance with generally accepted accounting principles and which
is made available to the public by providing a copy upon request or by posting the audit
on the organization’s website;
 Provides to the participants, on at least an annual basis, the total dollar amount of
qualified financial and medical needs actually shared in the previous year, or other
relevant time period, if the report is made more frequently than annually, in accordance
with criteria established by the organization;
 Provides a written disclaimer on or accompanying all applications and guideline
materials distributed by or on behalf of the organization that reads, in substance:
Notice: The organization facilitating the sharing of medical
expenses is not an insurance company, and neither its guidelines
nor plan of operation is an insurance policy. Whether anyone
chooses to assist you with your medical bills will be totally
voluntary, because no other participant will be compelled by law
to contribute toward your medical bills. As such, participation in
the organization or a subscription to any of its documents should
never be considered to be insurance. Regardless of whether you
receive any payments for medical expenses or whether this
organization continues to operate, you are always personally
responsible for the payment of your own medical bills.2
Under the bill, the Attorney General has the exclusive authority to determine whether
an organization meets the definition of a health care sharing ministry and, consequently,
qualifies for exemption from Ohio’s insurance laws.3 The implication being that the
Superintendent of Insurance would not have such authority.
The bill specifies that nothing in the Ohio Charitable Organizations laws is to be
construed as abrogating or reducing a right, privilege, or protection provided under certain
provisions of the Ohio and United States Constitutions pertaining to the following:
2 R.C. 1716.01(H).
3 R.C. 1716.22(B).
P a g e |2 H.B. 474
As Introduced
Office of Research and Drafting LSC Legislative Budget Office
 The right to assemble;
 Rights of conscience; education; the necessity of religion and knowledge;
 Freedom of speech; of the press; of libels;
 Preservation of the freedom to choose health care and health care coverage;
 The Right to Reproductive Freedom with Protections for Health and Safety;
 Fundamental freedoms of United States citizens;
 The prohibition against state laws that abridge the privileges and immunities of United
States citizens.4
Institutions of higher education
The bill specifies that any requirement made by a state institution of higher education
that attending students have health care coverage is met by participation in a health care
sharing ministry.5
Tax deduction
The bill allows a state income tax deduction for members participating in a health care
sharing ministry equal to the amount the member paid during the taxable year for membership
in the ministry. This includes all amounts paid for membership by the taxpayer, the taxpayer’s
spouse, and the taxpayer’s dependents.6 This deduction would apply to taxable years ending on
or after the bill’s 90-day effective date.7
Title
The bill designates itself as the “Health Care Sharing Ministries Freedom to Share Act.”
HISTORY
Action Date
Introduced 04-08-24
ANHB0474IN-135/ts
4 R.C. 1716.22(C).
5 R.C. 3333.96.
6 R.C. 5747.01(A)(44).
7 Section 3.
P a g e |3 H.B. 474
As Introduced


Statutes affected:
As Introduced: 1716.01, 5747.01