By Christopher Johnson – President and CEO of Portico Benefit Services
Originally published by the Minneapolis/St. Paul Business Journal. Republished with permission.
Across denominations, traditions and geographies, churches and nonprofits are confronting the same troubling reality: The rising cost of health care is making it increasingly difficult to provide health benefits to the people who serve our communities.
The pressures behind these increases are widespread and remarkably consistent. Hospital and provider costs continue to rise. High-cost specialty medications are being used more widely. Demand for care is increasing, and serious conditions such as cancer and heart disease require increasingly complex and costly treatment.
No single denomination, nonprofit or benefits organization is experiencing this alone. Employers and families across the country are confronting the same forces. But for churches and other nonprofits operating with limited resources, the consequences can be especially profound.
When the cost of health benefits rises significantly, a congregation can’t simply pass that increase along to customers. Church leaders are left deciding how limited resources will support compensation, benefits, staffing, programs and ministry. A nonprofit may face a similar choice between funding employee benefits and putting additional resources toward the community it exists to serve.
This continual financial squeeze is having a devastating impact on the people who care for our communities.
Pastors counsel families through grief and crisis. Lay church employees sustain ministries that provide food, shelter and support. Nonprofit employees work every day with people experiencing homelessness, hunger, addiction, isolation and other challenges.
These are people our communities depend on, and many have chosen careers of service knowing they could earn more elsewhere. At a moment when their work is needed more than ever, the organizations employing them are struggling to afford the health benefits that keep them healthy enough to serve others.
We believe business and civic leaders should understand what is happening and how they can help us advocate for change.
Through the Church Benefits Association, an interfaith network founded in 1915, more than 50 denominational benefit organizations collectively steward over $100 billion in pension and health plans for clergy and church workers. Together, we are sharing what we’re learning, evaluating new approaches and identifying opportunities to collaborate rather than tackling the same problems in isolation.
One example is coalition purchasing, which allows participating organizations to use their combined scale to negotiate more competitive rates and offerings than many could secure independently. Many of these organizations also participate in the Church Alliance, which advocates in Washington on public policy affecting the retirement and health care benefits provided to clergy and lay workers.
Across our organizations, teams are managing costs, evaluating strategic partners, strengthening member support and asking difficult questions about what must change and what must be preserved. We compete for every opportunity to make care more affordable because we understand what is at stake.
Still, there are limits to what benefits organizations can accomplish on their own.
The forces driving health care costs are much larger than any individual plan. Addressing them requires greater attention to what rapidly escalating costs mean not only for businesses, but for the institutions that form our nation’s social fabric and safety net.
We need greater attention to the underlying factors driving costs, including barriers to competition, limited transparency, and billing practices that increase costs without delivering better outcomes.
No single reform will solve the affordability challenge. Meaningful progress will require employers, health care organizations, policymakers, and community leaders to work together to address the root causes. The health of our communities depends in large part on the health of the people who care for them. They are counting on us to get this right, just as our communities continue to count on them.
For more information on the 2027 health care landscape, click here.
Portico Benefit Services, a ministry of the Evangelical Lutheran Church in America, is a church plan and provides health, retirement and related benefits for those who serve faith-based organizations. Portico supports the health and well-being of more than 5,000 congregations and more than 51,000 rostered and lay leaders and their families.
Christopher Johnson is president and CEO of Portico Benefit Services. With more than three decades of experience across financial services, health care and consulting, Johnson is a servant leader focused on building high-performing teams, strengthening organizational performance and advancing a shared mission of supporting the well-being of those who serve others.