President Obama signing health-care reform bill at the White House (White House photo)

The recent health-care reform legislation carries a controversial mandate that all Americans obtain health insurance, but careful study of the passed law reveals there are some groups – the Amish, for example – that can obtain an exemption.

For devout Muslims, however, whose religious beliefs forbid purchasing insurance, the mandate is still binding, religion or not. And most other religious, political or conscientious objectors will similarly find themselves out of luck if they hope to be excused from the requirement.

There is a clause in the fine print, however, that could provide an out for those willing to take it.

Section 1501 of the Patient Protection and Affordable Care Act adds a new chapter to the Internal Revenue Code mandating all “applicable” individuals either obtain health insurance that meets the bill’s “minimum essential coverage” standards or pay a penalty on tax day.

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Section 1501 also spells out exceptions, those who are not considered “applicable” individuals, both for the mandate and for the penalty. Illegal aliens, foreign nationals and incarcerated prisoners, for example, are exempt from the mandate. The extreme poor and members of Indian tribes, while not exempt from the requirement, are nonetheless excused from paying the penalty.

But section 1501 also carries a pair of “religious exemptions” that will allow the Amish to escape the mandate but require Muslims and other religious objectors to get creative.

The law creates a religious exemption for those who are members and faithful adherents of a “recognized religious sect or division” with “established tenets or teachings” barring the “acceptance of the benefits of any private or public insurance.”

For individuals who do not belong to a denomination with specific bans on insurance, therefore, personal religious objections will not exempt them from the mandate.

But even for Muslims, who may belong to a sect with clearly established teachings banning insurance, the bill still presents a problem.

For many Muslims, conventional health insurance is considered forbidden, because it is based on a system of uncertain outcomes akin to gambling on the future and the charging of interest.

The health-care reform bill’s language, however, specifically states that for a sect to qualify for the religious exemption, it must fall within the definitions of section 1402(g) of the Internal Revenue Code of 1986. That section requires a sect to have been in constant existence since at least Dec. 31, 1950, and requires the sect to reject not only insurance but also have sworn off receiving all benefits from the U.S. Social Security system.

According to the Young Center for Anabaptist and Pietist Studies website, traditional Amish groups may dodge the mandate because they have been exempted from participating in Social Security for decades.

“The Amish viewed it as a form of commercial insurance, which they opposed,” explains the website produced by Elizabethtown College in the Plain People country of Lancaster County, Pa. “They believe that members of the church should care for each others’ physical and material needs. Thus, most of them do not pay into Social Security or receive payments from it. In some states, the Amish have also been exempted from workers compensation (insurance for on-the-job injuries) for the same reason.”

For Muslims, however, Social Security is considered a form of caring for the poor, rather than an insurance gamble. While refusing typical insurance is common in Muslim circles, participation in the Social Security system is more widely accepted.

Most of the Amish, therefore, will qualify for the religious exemption, while most other Christians, Muslims and people of other religions will not.

Conscientious objectors to the mandate, also excluded from any exemption, have already voiced their intent to challenge the law because they don’t think the requirement is legal.

“If [the Amish] can do it for religious objection, well, I have a different type of objection,” Ilya Shapiro, a senior fellow in constitutional studies at the Cato Institute told Fox News. “I think I’m being coerced into doing something against my will, and so the challenge would be from a different perspective.”

Outside of court battles, however, this is one more way certain religious individuals may be able to slip out of the mandate.

How the non-Amish might still obtain an exemption

The Patient Protection and Affordable Care Act provides a second form of religious exemption, one for those who are members of “of a health-care sharing ministry,” which is defined as a non-profit, health-insurance alternative program, where members typically pay in regular dues and then contribute toward one another’s medical costs.

To qualify for the exemption, the Act requires a sharing ministry to meet the following conditions:

  • It must be a qualifying 501(c)(3) organization exempt from taxation under section 501(a)
  • It’s members must “share a common set of ethical or religious beliefs and share medical expenses among members in accordance with those beliefs and without regard to the state in which a member resides or is employed”
  • Its members must retain their memberships, even after developing medical conditions
  • The sharing ministry or its predecessor must have been in existence at all times since Dec. 31, 1999, and medical expenses of its members must have been shared continuously and without interruption
    since at least Dec. 31, 1999
  • It must conduct annual audits made available to the public on request and performed by an independent certified public accounting firm.

The Amish – thus double qualifying for exemption from the mandate – have participated in such co-ops for years. But there are also several such ministries established in the U.S. for people of other faiths and denominations.

Christian Healthcare Ministries, for example, is a 501(c)(3) cost-sharing ministry that claims its more than 100,000 members have shared more than $500 million in medical bills over the last 20 years.

“Christian Healthcare Ministries is not a health-insurance company,” the group’s website explains. “Rather, we are a group of thousands of Christians across the United States and around the world who share each other’s burdens in the area of health-care costs. We also pray for and encourage one another.”

Among similar groups are Medi-Share and Samaritan Ministries.

Muslims have also developed similar programs in line with the Islamic principal of takaful, or mutual sharing of one another’s needs. Dozens of these programs have sprung up throughout Arab nations since the 1960s but have been a newer phenomenon in the U.S. and are difficult to find. WND contacted several Islamic relations and education organizations as well as financial institutions and was unable to find a takaful-insurance program covering medical expenses for American Muslims.


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