Vermont is on the verge of making a serious constitutional error.
The Vermont House of Representatives has approved the language from H. 102, a bill that was defeated in 2025 but whose language was resurrected and quietly embedded as Section 10 of H. 585, a health care omnibus bill. This measure would subject Health Care Sharing Ministries (HCSMs), federally recognized 501(c)(3) nonprofit charities, to regulation by the state’s Insurance Division. The bill now heads to the Senate.
If it passes, the state will find itself embroiled in a costly legal battle it cannot win — one that tramples the First Amendment rights of hundreds of Vermont families already members of Health Care Sharing Ministries.
I know these communities well. I served in the U.S. Congress representing Illinois for eight years, and during that entire time, my family and I chose Samaritan Ministries over the Congressional insurance exchange because it aligned with our faith and values. For more than 12 years, I’ve experienced firsthand what makes health care sharing different: when I submit a medical bill, other members don’t just send money, they send cards, notes and prayers. This is not insurance. It is a voluntary community of faith.
And that distinction matters enormously — legally, practically and constitutionally.
Health Care Sharing Ministries are not insurance companies. Our members make a moral, not a contractual, commitment to one another. There are no premiums, no guaranteed benefits and no actuarial risk pools. The Affordable Care Act itself recognized this distinction, and 34 states have passed laws explicitly clarifying that HCSMs are not engaged in the business of insurance. Vermont should join them, not run in the opposite direction.
Instead, Section 10 of H. 585 would compel Christian ministries to hand over to state regulators a sweeping array of proprietary and sensitive information: the names of vendors and partners, external communications to members, operational and financial data, and details about how the ministry conducts its religious programs.
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To understand what this means in practice, ask yourself: would any faith organization in Vermont want to report to the government who its vendors are, how much it pays them, how and what it communicates with its congregation, and why it makes the financial decisions it does? Of course not.
The constitutional protections that guard churches protect HCSMs for the same reason: they are faith-based charities, not businesses subject to state insurance regulation.
The Alliance has identified four distinct constitutional problems with Vermont’s bill.
First, it violates the Establishment Clause. The U.S. Supreme Court has long held that the government may not “foster an excessive entanglement with religion.” Placing a religious ministry under continuous state monitoring and requiring it to justify its financial decisions to a government agency does exactly that.
Second, it violates the Free Exercise Clause. Vermont’s bill singles out ministries, organizations defined by their religious identity, and subjects them to burdens not imposed on comparable secular organizations.
Third, the Free Speech Clause is at stake. The bill would require ministries to disclose how much of members’ monthly contributions go toward sharing medical expenses versus communications, forcing religious organizations to expose the balance between their charitable and evangelistic activities to government scrutiny. Compelled disclosures of this kind violate the First Amendment’s protection against compelled speech.
Fourth, freedom of association is implicated. The Supreme Court’s decision in Americans for Prosperity v. Bonta makes clear that “the government cannot compel an organization to disclose its members or affiliates without a compelling interest.” This bill requires exactly that, with no compelling interest demonstrated.
The Alliance concludes that “many of these constitutional concerns would subject the legislation to strict scrutiny,” and that it is “hard to see how this legislation could survive that test.” Vermont lawmakers should take this warning seriously. The Alliance is already litigating against Colorado’s nearly identical law at the Tenth Circuit Court of Appeals. Vermont would simply be inviting the same fight — at taxpayer expense.
Meanwhile, HCSMs are not unregulated. Every state’s Attorney General has jurisdiction over charities and nonprofits, and Vermont’s existing consumer protection laws under Title 9 of Vermont Statutes already prohibit deceptive or fraudulent conduct. Vermont’s Department of Justice retains full authority to investigate and act against bad actors. No regulatory gap exists that demands this bill.
Transparency concerns are also addressed effectively through private accreditation. The Health Care Sharing Accreditation Board imposes more than 65 standards covering governance, transparency and internal processes. Annual IRS Form 990s are publicly available. Sharing guidelines are published on every ministry’s website. These tools already give Vermonters everything they need to make informed decisions, without the state trampling on religious liberty. And notably, placing HCSMs under the Insurance Division’s oversight would itself mislead Vermonters into thinking these ministries are insurance — the very outcome everyone says they want to avoid.
At its core, this debate is about more than health policy. It is about whether the government can redefine a religious ministry to fit a regulatory framework that does not apply. It is about whether faith-based communities can operate according to their beliefs without undue interference.
Vermont lawmakers still have an opportunity to get this right. They can protect consumers while respecting constitutional boundaries by relying on existing oversight mechanisms and encouraging voluntary transparency.
If they fail to do so, they risk inviting costly litigation and, more importantly, eroding fundamental freedoms that should not be up for negotiation.
The Vermont Senate should reject Section 10 of H. 585. This isn’t a transparency bill. It is an unconstitutional intrusion into the internal affairs of faith communities. Vermont should regulate HCSMs the way it properly regulates all nonprofits — through the Attorney General — and leave religious ministries free to serve their members as their faith compels.
Randy Hultgren is Executive Director of the Alliance of Health Care Sharing Ministries and a former U.S. Representative from Illinois.
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