But they do serve the same basic function, which is to pool money to share the cost of its members’ health care.

Christian Health Ministries, the first such group, requires members to be Christians “living by biblical principles.”

Unlike traditional insurers, it does not have a contract with its members, but points to its three decade record as evidence that it can be trusted to help cover a share of its members medical expenses.

Thus, some groups specifically bar their members from suing over uncovered bills.

PPACA allowed such groups––those that have been operating continuously since 1999––to continue their operations exempt from the new law’s regulations.

The exemptions are notable; some do not cover preventative care, for instance.

The Journal reports that the ministries are particularly popular among Amish and Mennonite communities, both of which have historically taken great lengths to separate themselves from other civic programs or institutions, such as public education or the military draft.

Some regulators have long voiced concerns that such ministries are treated differently, and PPACA hasn’t changed that.

In fact, in their attempts to bring down premiums for plans offered through the private insurance exchanges by getting more healthy people to sign up, state insurance commissioners may look at health care ministries as an obstacle if it appears that their members are disproportionately younger and less sick.