'Amish Exemption' to Obamacare Rule Available Without Internet

10/26/2013 7:00 AM
By Philip Gruber Staff Writer

A paper application will soon be available to allow members of certain religious groups to avoid tax penalties for not having health insurance.

The exemption, which will protect Amish and Old Order Mennonite farmers, will be granted through paper application at least through October 2014, according to a final rule the Department of Health and Human Services published July 1 in the Federal Register.

The Affordable Care Act, the 2010 law nicknamed Obamacare, created an individual mandate that all U.S. citizens either purchase health insurance or pay a tax penalty.

Many exemptions from this penalty, such as membership in a Native American tribe or experience of only a short coverage gap, can be handled on one’s tax return.

However, “the statute specifies that the religious conscience exemption and the hardship exemption are available exclusively through a Health Insurance Marketplace or Exchange,” Department of the Treasury spokesman Anthony Reyes said in a press release.

Healthcare.gov, the federal health insurance marketplace that serves Pennsylvania and most other states, is the most visible part of the exchanges, but Plain Sect people will not have to use the Internet, which they avoid for religious reasons, to seek the exemption. People will not have to violate their beliefs about electricity to follow their beliefs about insurance.

Lancaster Farming had initially reported on the apparent incompatibility of an online exemption with the Amish lifestyle in its Oct. 5 issue. At that point, it was unclear how Plain Sect people were to apply for the exemption because most government workers informed about those regulations were furloughed as part of the federal shutdown.

The draft applications for the various exemption categories were posted recently for a 30-day public comment period. After that period is completed, the Centers for Medicare and Medicaid Services will review the comments and release the official forms.

The government has not yet determined how exemption applications should be submitted after Oct. 15, 2014, the date the current provision for mailing an application will expire.

Because the individual mandate applies to federal income taxes due on April 15, 2014, all Plain Sect people will have had time and reason to submit a paper application by the time the mailed application provision expires.

Although the marketplace has no time limit for filing an exemption, a source at the Medicare Services Centers said that IRS rules about applying for tax refunds make it likely that applicants would seek the exemption for the current tax year rather than putting it off.

The Federal Register notes that several people who gave comments on the exemption rule suggested that all means of applying for insurance on the exchange — phone, mail, in-person, online — be available to people seeking exemptions from insurance.

The exemption application can be mailed by itself or along with one’s taxes, according to the Congressional Research Service. The mailing address for the paperwork is omitted on the draft application but will be included on the final form.

Although a religious conscience exemption does not need to be renewed yearly, people who are exempted as children will need to reapply for the protection once they reach age 21. The exemption lasts until the month after a person turns 21, and the government will mail a notice enabling the person to renew.

If the applicant has a copy of IRS Form 4029, which exempts certain religious groups from participation in Medicare and Social Security, that document should be mailed with the rest of the application.

Applicants for the religious conscience exemption must belong to a religious group that is exempt from Social Security.

If a person requests the insurance exemption as a member of a faith that Social Security does not recognize, the government will provide that person with materials to apply for exempt status for that group. In that case, the applicant is ineligible for the exemption until the group’s status is confirmed.

The exemption process will look similar in New York, a state that has its own health exchange and does not use the federal marketplace.

Marci Natale, the deputy director of the Public Affairs Group at the New York State Department of Health, said New York is deferring to the federal government on granting exemptions.

The Amish and Mennonites are not the only religious groups concerned about the Affordable Care Act’s effects on their religious beliefs.

Last year, Roman Catholics voiced concern about the government’s classification of birth control, which their church rejects, as essential minimum coverage that all insurance on the exchanges must provide.

Mennonite-owned Conestoga Wood Specialties in East Earl, Pa., lost a Third Circuit Court of Appeals case on the same issue in July.

Christian Science practitioners are seeking a religious conscience exemption of their own. According to the group’s website, the insurance offered on the exchanges would likely not include the kind of care Christian Scientists use, and the current exemption criteria exclude them.

Christian Science adherents place great, sometimes exclusive, emphasis on prayer for healing and have little involvement in mainstream health care.

The religious conscience exemption is not universally accepted. The final rule on exemptions printed in the Federal Register acknowledged some commenters’ philosophical resistance to exemption for religious reasons.

Others feared exemption would allow parents to neglect their children’s health.

HHS responded that state laws allow parents to speak for minor children, but Affordable Care Act regulations do not supersede parents’ responsibility to care for their children.

Don McCanne, a senior health policy fellow at Physicians for a National Health Program, wrote in an article on the group’s website that ending the religious exemption is a matter of taxation fairness.

“Should a person be required to pay taxes into a universal health care system? I can answer that by stating, as a pacifist, I vehemently object to paying taxes to fight wars. Yet, I cannot be allowed the option of withholding my allocated tax assessment assigned to our nation’s military ventures,” he wrote.

“Nor can anyone be allowed to opt out of paying taxes for any public service that, through our democratic process, we decide to provide for the public good. That includes health care,” McCanne wrote.

The draft religious conscience exemption form can be found here.


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