For many Christians, God isn’t just their copilot—he’s their lawyer, too. And he’s a good one, with lots of ways to get around laws and regulations that they’d rather not obey.
Consider two of the most contentious Supreme Court decisions of the last few terms: King v. Burwell, which preserved Obamacare, and Obergefell, which gave gay couples the right to marry. Both of these cases were high-wattage media affairs and possibly historic moments.
But if you’d prefer not to obey them, with the right amount of religion, that’s not too hard to do.
Obamacare first. As is well known, closely-held corporations can opt out of part of Obamacare if they (the corporations that is) have a religious reason for doing so.
Less well known is that, thanks to a carve-out created by three centrist legislators (two Democrats and one Republican), anyone can decline to buy insurance by instead participating in a “health care sharing ministry,” or an HCSM. Affordable Care Act be damned... or blessed, I guess.
The way HCSMs work is deceptively simple. Instead of buying insurance from an insurance company, members sign up for these “ministries” and pay a monthly fee—usually far less than an insurance premium. When accidents happen, the ministry members “share” (i.e., pay) the health-care costs, just as an insurance company might.
In a way, HCSMs are like Uber for the home-schooling crowd: a phony “sharing economy” that is actually a clever end-run around regulation. In fact, though, the model dates back to the old Mutual Aid Societies of the 19th century, which worked similarly. In its contemporary forms, it works primarily for three reasons.
First is the religious element. Members must make all kinds of promises: abstaining from tobacco and alcohol, for example. No pre- or extra-marital sex either.
And HCSMs generally don’t cover “immoral” expenses like contraception. Such provisions please the consciences of members, and also keep expenses down. Of course, they also exclude lots of people (gays, atheists, etc.) but that comes with the territory.
Second, HCSMs are often able to negotiate away significant portions of outstanding medical bills. Some small percentage of that power may be due to their nonprofit religious status. More likely, since members are technically uninsured and payment is not guaranteed, HCSMs have strong bargaining positions. For hospitals, their offer is always better than the alternative, which is nothing.
Third, and most troubling, is that HCSMs are not required to pay particular expenses, and are not required to maintain any of the base-level coverage that the Affordable Care Act was meant to guarantee. Those with pre-existing conditions may be excluded. And all HCSMs say that not all expenses may be “shared.”
In other words, beneath their (sincere) religious rhetoric, HCSMs are actually a kind of legalized gambling. You pay in less, but you might get stuck with a bill later.
Now, this may seem odd, since it’s exactly the sort of gamble the ACA was supposed to end. By requiring everyone to buy insurance, the ACA could eliminate the worst plans, and guarantee a base level of coverage for everyone.
But since they are religious in nature, HCSMs can be both Cadillac plans and Lemons: Cadillac in that they poach some of the best customers (no pre-existing conditions, no medically costly behavior), Lemon in that they can still stick them with the bill.
Of course, if you get seriously ill, that’s just God’s plan for you. Too bad you don’t have a health plan.
How is any of this legal? Because religion. And winning over moderate votes in order to pass the ACA.
Further, in a neat twist of pork-barrel politics, the only HCSMs that are allowed to exist are those in operation since before 2000. There are exactly four: Medi-Share, Christian Healthcare Ministries, Liberty HealthShare (the only one open to non-Christians), and Samaritan Ministries.
But if you’d like to join the Lamb and the 350,000 (that’s a Revelation reference for you heathens out there), or if you just don’t like Obamacare and are willing to quit drinking and risk not getting paid for your gall bladder surgery, consider signing up. As one of the four providers said, “Still looking for an affordable, God-honoring healthcare solution? The doors are always open.”
Fear not! Not only has a constellation of religious exemptions to civil rights laws appeared across the United States (in Utah, Arkansas, Mississippi, and North Carolina most notably), but if you’re running an organization that has anything to do with religion, the folks at Alliance Defending Freedom have a way to weasel around any civil rights law that might offend your sense of decency.
Warning of “the gathering spiritual darkness,” it urges organizations to revise their internal documents and contracts, reclassifying all employees—even janitors—as “ministers” to take advantage of the ministerial exemption to anti-discrimination law.
A similar handbook published by the Liberty Institute asks, “What’s the solution to protecting yourself from religious attacks? In a word, religify.”
Well that’s a new one—literally. Whether a given position, facility, or program is authentically religious or not, organizations and corporations can “religify” it to make it seem as though it is.
Wait, but isn’t that legally lying—forbidden by the Ten Commandments? Never mind.
Worse, these Discrimination Handbooks are openly distorting Supreme Court doctrine. In a 2012 decision, the Court ruled 9-0 that the “ministerial exemption” to civil rights laws covered not just ministers per se but anyone performing a ministerial function: Sunday school teachers, for example. Conservatives and (most) liberals alike cheered this ruling.
But now the religious conservatives have run wild with it. Now, you can fire your school cafeteria worker for being a lesbian, or your English teacher for pursuing IVF because she is infertile. Now your private corporation can deny health benefits to your gay employee’s husband, because after all, your corporation is religious. And now you can flout anti-discrimination law and turn gays away from your hotel chain, because, hey, you’ve religified.
So, let’s stop talking about a few bakeries and pizzerias—these were always beside the point. The real issue is that while liberals may have won a few rounds at the Supreme Court, lurking in the cracks of the law are religious carve-outs that could eventually erode its foundations. And that is the point.