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How a lobbyist, a senator, and a colleague's death carried a religious exemption into federal law — and delivered it, four years later, to a family already once implicated in the collapse of the model it was named for
In 2007, the trade group formed in the wake of the Christian Brotherhood Newsletter's collapse hired a lobbyist named Joe Guarino. His mandate was narrow and, on paper, unlikely to succeed: get health care sharing ministries carved out of whatever health care reform Washington eventually passed. He was, by his own account, badly outmatched by the health insurance industry's lobbying operation. He kept working anyway.
It wasn't the industry's first fight of this kind. In the 1990s, as state regulators began scrutinizing the Brotherhood directly — Arkansas's attorney general once said it had every mark of a "phony con job" — the ministry hired its own lobbyists and pushed state legislatures to pass safe-harbor laws exempting cost-sharing arrangements from insurance regulation entirely. By 1994, ten states had done so. Guarino picked up that same state-by-state campaign in 2007, hiring local lobbyists in state after state. By 2008, fifteen states had a safe harbor on the books. None of it drew national attention. It didn't need to.
The real opportunity came in 2009, when President Obama's health care overhaul put a federal individual mandate on the table — a requirement that every American carry insurance or pay a penalty. For an industry whose entire membership had joined specifically because they didn't want to carry insurance, this was existential. Guarino met with roughly 150 congressional staffers over the following months. The break came through an Iowa state legislator he knew, who connected him to her home-state senator: Chuck Grassley, a senior Republican on the Senate Finance Committee.
Grassley and Guarino built language exempting health care sharing ministry members from the mandate on religious grounds, and Grassley worked it into the Senate's version of the bill. The House version, favored by most Democrats, didn't include it. Had the House bill prevailed in the final negotiations between the chambers, the exemption — and, by the trade association's own later account, quite possibly the industry along with it — would have died in conference.
The mandate itself never touched most Americans' daily lives — a majority already had coverage through an employer, Medicare, or Medicaid. The exemption did something quieter and more consequential. Unlike Form 4029, it required no sect membership, no HHS certification, none of the verification an actual Amish applicant has to clear. It required a 501(c)(3), a shared statement of belief, and an operating history that reached back to 1999. Membership in health care sharing ministries went from roughly 100,000 people the year the exemption passed to over a million within eight years.
The provision didn't specify who could walk through the door it opened. In 2014, one of the people who did was Dan Beers of Canton, Ohio — the nephew and mentee of Bruce Hawthorn, the same Ohio preacher whose newsletter collapsed in scandal thirteen years earlier.
Beers and his family incorporated a new sharing ministry that year, built by combining two existing nonprofit shells — the Gospel Light Mennonite Church Medical Aid Plan and the National Coalition of Health Care Sharing Ministries — under a new name: Liberty HealthShare. Its CEO, Dale Bellis, had been the Brotherhood's communications director. Its vice president, Drudy Abel, was Beers' sister and another Brotherhood alum. A former Liberty chief medical officer later told investigators he was troubled to discover that nearly every one of the ministry's top executives had worked at the Brotherhood before it collapsed.
At least three separate people have publicly taken credit for crafting the ACA's health care sharing ministry exemption — Guarino, in one investigation's account; a second lobbyist named Martin Hoyt, in a PBS interview; and congressional staff crediting then-Rep. Tom Perriello and Sen. Max Baucus, in earlier reporting. That the authorship itself is contested is not a contradiction — it's confirmation. A provision drafted in the open, fought over publicly, doesn't produce three separate people claiming sole credit years later. This one did, because almost no one outside the process was watching it happen.
The mechanism that actually delivered it was not persuasion. It was arithmetic. Sen. Kennedy's death in August 2009 cost Senate Democrats the votes needed to pass a revised bill through the normal process. A health event unrelated to health care policy is what put the exemption into law — not the merits of the argument for it.
Liberty HealthShare's founding shell wasn't invented from nothing, either. One of the two nonprofits merged to create it — the Gospel Light Mennonite Church Medical Aid Plan — carried a genuine Mennonite charter and history. The new venture didn't just inherit a legal exemption built in the name of communities like this one. It inherited an actual piece of one, folded directly into its corporate structure.
The 1965 statute asked who was in the community. The 2010 statute never had to ask.
— The Waiver, Part IIThis post does not argue that Chuck Grassley or Joe Guarino set out to hand a family already implicated in one ministry's collapse the tools to build another. Legislative intent isn't the finding here, and nothing in the record shows either man knew who would eventually use the provision they built. What's demonstrable is narrower: the exemption they wrote required no verification of who was using it, and the first major test of that omission arrived within four years, wearing a familiar name.
This is Post II of a three-part series. Post III — Out of Our Purview — follows the money into Liberty HealthShare itself: the $140 million paid to vendors the Beers family also controlled, the coverage ratio that would be illegal for an insurance company, and what a state regulator says on the record when asked why none of it can be stopped.
The Guarino lobbying campaign — his 2007 hiring by the Alliance of Health Care Sharing Ministries, the roughly 150 congressional staffer meetings, the connection to Sen. Grassley through an Iowa state legislator, and the exemption's survival through the mechanics of Sen. Kennedy's death — is drawn from ProPublica's December 2023 investigation, "How Obamacare Enabled a Multibillion-Dollar Christian Health Care Cash Grab," corroborated by its syndicated republication at Talking Points Memo, both treated as a single Tier 1 source rather than independent corroboration. The competing lobbyist-credit claim naming Martin Hoyt is drawn from a January 2018 PBS NewsHour report. The 1994 and 2008 state safe-harbor law counts, and the Arkansas Attorney General's characterization of the Brotherhood, are drawn from ProPublica's February 2023 investigation, "How Liberty HealthShare Left Thousands With Debt." Dan Beers' identification as Bruce Hawthorn's nephew and mentee, Liberty's 2014 founding through the merger of the Gospel Light Mennonite Church Medical Aid Plan and the National Coalition of Health Care Sharing Ministries, and the shared Brotherhood alumni among its founding leadership are drawn from the same investigation, cross-checked against its syndicated appearances at Cleveland Scene and MinistryWatch — again treated as one source, not several. Membership growth figures, roughly 100,000 in 2010 to over one million by 2018, are drawn from Wikipedia's health care sharing ministry entry, cross-confirmed against PBS NewsHour's reporting of Alliance-provided figures.
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