Blog - Amish and Other Religious Groups Exempted from the Individual Mandate

Since the 1930’s, the Amish have been exempt from paying Social Security taxes. The Watertown Daily Times, which is from a region of northern New York that many Amish families call home, notes that under Congress’s health care bills, the Amish would also get an exemption from the mandate to have “acceptable” health insurance or pay a tax penalty if you don’t:

Federal health care reform will require most Northern New Yorkers — but not all, it turns out — to carry health insurance or risk a fine.

Hundreds of Amish families in the region are likely to be free from that requirement.

The Amish, as well as some other religious sects, are covered by a “religious conscience” exemption, which allows people with religious objections to insurance to opt out of the mandate. It is in both the House and Senate versions of the bill, making its appearance in the final version routine unless there are last-minute objections.

Although the Amish consist of several branches, some more conservative than others, they generally rely upon a community ethic that disdains government assistance. Families rely upon one another, and communities pitch in to help neighbors pay health care expenses.

Both the Senate and House bills use the old Social Security language (Sec. 1402(g)(1) of the tax code) to determine who will be eligible for a “religious conscience” objection to the insurance mandate. Specifically, the bills would provide exemptions for adherents of “recognized religious sects” that are “conscientiously opposed” to accepting benefits from any insurance — private or public — “which makes payments in the event of death, disability, old-age, or retirement or makes payments toward the cost of, or provides services for, medical care.” To qualify for the exemption, the sect would have to have been in existence continuously since Dec. 31, 1950.

The language is very limiting. Christian Scientists, for example, would not be eligible for the exemption because they are not conscientiously opposed to having health insurance. “Some [Christian Scientists] have health insurance, and most probably have life insurance,” says the FAQ page of the official CS church website. “Every Christian Scientist makes his or her own financial and health decisions.” It’s limited essentially to the Amish and Old Order Mennonites

But the Senate bill adds a new religious exemption beyond what already exists for Social Security taxes and beyond what’s in the House bill. It would allow members of “Health Care Sharing Ministries” to be exempt from the requirement to have “acceptable” health insurance.

What exactly are “Health Care Sharing Ministries?” According to the bill, they are non-profit organizations that “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.” The Alliance of Health Care Sharing Ministries website explains that members pay a monthly fee that is pooled and shared to members that have medical bills. A monthly publication lists the medical bill needs of its members and tells who received payments that month. “The personal approach of need sharing ministries facilitates Christians to bear one another’s burdens in a very tangible way,” the site explains.

Photo of an old Amish farm house kitchen by csyork65 used under a CC license.