Healthcare sharing ministries aren't for everyone. In general, members must be practicing Christians attested to by their pastor in some cases and abstain from tobacco and illegal drug use. They must agree not to have sex outside marriage and typically cannot seek help for any medical expenses that arise from such sexual activity. Rules vary about when or if the ministries cover preexisting medical conditions. Although the ministries say that they're not providing health insurance and are therefore exempt from state insurance regulations, states sometimes beg to differ. Concerned that members may believe such ministries guarantee coverage of their medical bills, regulators have at times tried to shut them down. "They've made a commitment to what is effectively health insurance, that when you need to have your medical bills paid they'll help or will pay those costs for you," says Mike Kreidler, Washington state's insurance commissioner.