Tom’s post on a woman in Massachusetts getting screwed on a cost-sharing ministry health payment plan is a good opportunity to talk about the alternatives to ACA individual market qualified health plans (QHPs) for people who want some cost protection. The ACA explicitly allowed for Cost Sharing Ministries as an exception to the individual mandate. These ministries were small at the time but have gotten larger as both a means of avoiding the ACA as an ideological committment and more often, as a means of getting some cost protection at a lower monthly output than an ACA plan would cost for someone who is not subsidy eligible.