“I just think it’s a crying shame, like so many of us do,” Sullivan said. The cancer screening is the only recent preventive care she’s had.

She feels sick again now, at the beginning of April. “I’m almost 60 years old and I can’t go see a doctor.”

Sarah Yoder and her 8-year-old daughter walked out of their pediatrician’s office in early February before the appointment began. Her family dropped their health insurance plan the month before, and the clinic didn’t offer a discount for paying cash. The checkup would have cost $150.

“It makes me crazy, because they’re not even getting that much money from the insurance company,” Yoder said.

Yoder’s family of six lives in Fort Defiance, Virginia, and had been insured last year through her husband Nevin’s job as a nurse practitioner. With Sarah’s work at a construction company, their combined pre-tax income is around $140,000. But their health premiums for this year were going up by $300 to $1,400 a month. That was too much for a plan with a $7,500 deductible, they decided.

Their 4-year-old son was born with a heart condition and genetic disorder. He still qualifies for Virginia’s Medicaid program. The rest of the family joined a Christian health-care cost-sharing ministry for $350 a month.

Yoder’s daughter will get her checkup at the family practice where Sarah goes, because it offers a discount to patients in their health-sharing ministry. Yoder needed medication herself for a psoriasis outbreak in January. She called several pharmacies to check prices, and a coupon cut the price of the topical steroid Clobex to $125 from $600.

So far, they’re ahead. Yoder estimates their out-of-pocket expenses are about what they would have paid with insurance. Money saved on premiums goes into a separate bank account for medical expenses.

“We’re still allocating the same amount of funds. We’re just holding on to more of it,” Yoder said. She hopes the health-sharing plan will protect them from financial ruin in an emergency.

“I think we’re going to be covered if there’s a catastrophe,” she said. “But I don’t know for sure.”