The Affordable Care Act From A Christian’s Worldview

Photo courtesy of the Cincinnati Enquirer

The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 by President Barack Obama. There are few laws enacted by our legislature in the history of the United States that have been fraught with more division among Christians than the ACA or “ObamaCare”. Far too often, discussions about this topic are filled with partisan talking points, strong emotions, cliché arguments, and misinformation on all sides.

But we as Christians are to look at the world differently. Jesus does not call us to look at the world through Republican, Democrat, or Tea Party “glasses”. Rather, we are heirs of a King (Titus 3:7) whose Kingdom is “not of this world” (John 17:14, 18:36). Philippians 3:20 says, “our citizenship is in heaven” and that citizenship is not in an earthly nation or government. When we remove our partisan, earthly glasses and struggle to look at the world through the eyes of our Savior, the view is dramatically different from any other pair of political “spectacles”.

A few weeks ago I emailed a group of Christians whose political and social perspectives ranged from one extreme to another. But they all had in common a deep love for God and for his people. I asked them to list for me their key spiritual, “Kingdom” concerns about the Affordable Care Act. They sent me a number of thoughts and as I sifted through their fears, I realized that many of their anxieties were based on misinformation, false rumors, or just the unknown. And so, I researched many of their suggestions and compiled what I hope my readers find is helpful and unbiased information from a Christian’s worldview. I plan to make this a “working document” that I will update with the latest information as it becomes more available. I welcome your thoughtful, spirit-filled comments and suggestions for other discussion points.

Employer Mandate:

“Employers are forced to provide insurance that reimburses for abortions” or “I am afraid my money is going to fund abortions”

DISCUSSION: This is an ever-changing mandate that has been challenged many times in the last few years. At present, the Affordable Care Act does mandate employers with 50 or more employees to provide health insurance to their employees. This insurance must provide certain essential services, including the mandate to cover contraceptive services. According to HHS, these services include drugs like “Plan B” or the “Morning-After Pill” which many view as an abortive medication. However, many have filed lawsuits to fight this mandate.

Certain religious organizations (like churches and other organizations whose purpose is primarily religious) are exempt from the contraception mandate).⁵

In July, 2013, the White House announced it would delay the employer mandate until January 2015. ⁴

On November 1, 2013, in Gilardi v. Department of Health and Human Services, the federal court determined, that the contraceptive mandate imposed by the Act trammels the right of free exercise—a right that lies at the core of our constitutional liberties—as protected by the Religious Freedom Restoration Act.”³

1. http://www.ca10.uscourts.gov/opinions/12/12-6294.pdf. Accessed October 27, 2013.

2. http://www.snopes.com/politics/medical/hobbylobby.asp. Accessed October 27, 2013.

3. https://www.documentcloud.org/documents/814108-gilardi-vs-hhs.html. Accessed November 7, 2013.

4. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/07/02/white-house-delays-employer-mandate-requirement-until-2015/. Accessed November 7, 2013.

5. http://www.gpo.gov/fdsys/pkg/FR-2012-02-15/pdf/2012-3547.pdf. Accessed November 7, 2013.

6. 1. http://www.kaiserhealthnews.org/Stories/2013/September/18/contraception-mandate-challenges.aspx. Accessed November 7, 2013.

SCRIPTURE REFERENCES:

Genesis 1:27: “God created man in his image; in the divine image he created him; male and female he created them”.

Psalm 127:3: “Truly children are a gift from the Lord; the fruit of the womb is a reward”.

Psalm 139: 13,15: “You knit me in my mother’s womb . . . nor was my frame unknown to you when I was made in secret”.

Exodus 20:13: “Thou shalt not kill” and Christ reaffirms it (Matthew 19:18).

Sex Change Surgeries:

“Sex change is paid for by ObamaCare”

http://www.afa.net/Blogs/BlogPost.aspx?id=2147486140 accessed November 7, 2013.

DISCUSSION: Sex change is not reimbursable by Medicare or Medicaid under the new Affordable Care Act law.¹

1. http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=83&ncdver=1&bc=AgAAQAAAAAAA&. Accessed October 27, 2013.

SCRIPTURE REFERENCES:

Not a true statement.

Health Care For the Poor:

“ObamaCare will help the poor”

DISCUSSION: The Affordable Care Act places rules in place that work to provide health care to low-income populations in the following ways:

• Medicaid Expansion: Federal funds are offered to states that choose to expand Medicaid. This will expand Medicaid eligibility to families and individuals up to 133% of the Federal Poverty Level. Some argue that since this mandate was determined to be unconstitutional by the Supreme Court⁵, many of the poorest of the poor will still not have access to affordable health care.⁴
• Health Insurance Exchanges have been set up and subsidies will be provided to people falling between 100% and 400% of the FPL.³
• Health Insurance companies will be forced to limit out-of-pocket expenses to help the poor from going bankrupt from medical expenses. This provision has been delayed until 2015.^1,2

1.http://www.dol.gov/ebsa/faqs/faq-aca12.html#3. Accessed November 7, 2013.

2. http://www.marketplace.org/topics/economy/health-care/another-obamacare-delay-out-pocket-limits-pushed-2015. Accessed November 7, 2013.

3. http://kff.org/interactive/subsidy-calculator/. Accessed November 7, 2013.

4. http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/. Accessed November 7, 2013.

5. http://kff.org/health-reform/issue-brief/a-guide-to-the-supreme-courts-decision/. Accessed November 7, 2013.

SCRIPTURE REFERENCES:

Leviticus 19:9-11: When you reap the harvest of your land, do not reap to the very edges of your field or gather the gleanings of your harvest. ¹⁰ Do not go over your vineyard a second time or pick up the grapes that have fallen. Leave them for the poor and the alien. I am the LORD your God.

Deuteronomy 15:11: There will always be poor people in the land. Therefore I command you to be openhanded toward your brothers and toward the poor and needy in your land.

Psalm 82:3-4: Defend the cause of the weak and fatherless; maintain the rights of the poor and oppressed. Rescue the weak and needy; deliver them from the hand of the wicked.

Proverbs 14:31: He who oppresses the poor shows contempt for their Maker, but whoever is kind to the needy honors God.

Proverbs 19:1: Better a poor man whose walk is blameless than a fool whose lips are perverse.

Proverbs 19:17: He who is kind to the poor lends to the LORD, and he will reward him for what he has done.

Proverbs 21:13: If a man shuts his ears to the cry of the poor, he too will cry out and not be answered.

Proverbs 22:2: Rich and poor have this in common: The LORD is the Maker of them all.

Proverbs 29:7: The righteous care about justice for the poor, but the wicked have no such concern.

Job 30:25: Have I not wept for those in trouble? Has not my soul grieved for the poor?

Isaiah 61:1: The Spirit of the Sovereign LORD is on me, because the LORD has anointed me to preach good news to the poor. He has sent me to bind up the brokenhearted, to proclaim freedom for the captives and release from darkness for the prisoners…

Jeremiah 22:16: He defended the cause of the poor and needy, and so all went well. “Is that not what it means to know me?” declares the LORD.

Zechariah 7:10: Do not oppress the widow or the fatherless, the alien or the poor. In your hearts do not think evil of each other.

Matthew 25:37-40: Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you? The King will reply, ‘I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’

Mark 10:21: looked at him and loved him. “One thing you lack,” he said. “Go, sell everything you have and give to the poor, and you will have treasure in heaven. Then come, follow me.”

Luke 12:33: Sell your possessions and give to the poor. Provide purses for yourselves that will not wear out, a treasure in heaven that will not be exhausted, where no thief comes near and no moth destroys.

Luke 14:12-14: Then Jesus said to his host, “When you give a luncheon or dinner, do not invite your friends, your brothers or relatives, or your rich neighbors; if you do, they may invite you back and so you will be repaid. But when you give a banquet, invite the poor, the crippled, the lame, the blind, and you will be blessed. Although they cannot repay you, you will be repaid at the resurrection of the righteous.”

1 Corinthians 13:3: If I give all I possess to the poor and surrender my body to the flames, but have not love, I gain nothing.

James 2:5: Listen, my dear brothers: Has not God chosen those who are poor in the eyes of the world to be rich in faith and to inherit the kingdom he promised those who love him?

Forced Abortions:

“Doctors could be forced to facilitate abortions or prescribe drugs that violate their convictions.”

http://www.cbn.com/cbnnews/us/2013/October/Obamacare-May-Trigger-Exodus-of-Christian-Doctors/, accessed October 2, 2013.

DISCUSSION: This is not true. There is no mandate for doctors to facilitate abortions. There is no evidence to support this.

SCRIPTURE REFERENCES:

Not a true statement.

Christian Health Care Sharing Ministries are Exempt:

“Sharing ministries are exempt from the individual mandate penalty.”

DISCUSSION: The ACA allows those participating in Christian Health Care Sharing Ministries to be exempt from the individual mandate penalty if they meet certain criteria.¹ These plans do not pay for abortions, “morning after pills”, or for other specified lifestyle choice interventions².

There are only three organizations in the nation that qualify for these exemptions:

• Medi-Share: http://mychristiancare.org/medi-share/.
• Christian Healthcare Ministries: http://www.chministries.org
• Samaritan Ministries: http://samaritanministries.org

1. http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf. (p. 107, 128) Accessed November 7, 2013. 2. http://mychristiancare.org/medi-share/. Accessed November 7, 2013.

SCRIPTURE REFERENCES:

Galatians 6:2: “Carry each other’s burdens, and in this way you will fulfill the law of Christ.”

Acts 2: http://www.biblegateway.com/passage/?search=Acts%202&version=NIV

Acts 4: http://www.biblegateway.com/passage/?search=Acts%204&version=NIV

The Hobby Lobby [(v) to urge or procure the passage of (a bill), by lobbying.]

On January 1, 2013, under The Patient Protection and Affordable Care Act (aka “ObamaCare”),  a part of the law was enacted, giving authority (PHS Act section 2713(a)(4)) to the U.S. Department of Health and Human Services to develop preventative health regulations. These regulations mandate that employers provide insurance to eligible employees and that they pay for certain women’s preventative services at no cost to their beneficiaries. These services include “all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” (1). Some of these medications are drugs like, “Plan B” which the FDA says work “by preventing attachment (implantation) to the womb (uterus)” (6). The law does provide exemption from this part of the law to certain religious organizations. (2) However, on December 26, 2012, Supreme Court Justice Sonia Sotomayor rejected Hobby Lobby’s request to temporarily stop the enactment of the regulation (3) ruling that the retail store chain owned and operated by Christians (The Green Family), could not be classified as an exempt “religious organization.” On January 4, 2013, CEO David Green (Net worth: $4.5 billion)(4), penned a letter (5) that stated his heartfelt beliefs and concerns about these newly enacted regulations-it quickly went viral.

I have really struggled with this part of the law and I wondered how I would respond to such a mandate. These are a few of my thoughts:

1. An Assault on Religious Freedoms: This law, and the associated HHS regulation, imposes upon those who lead companies a “tax” that pays for abortive drugs. There is no doubt in my mind that if I were David Green, I would not be OK with this. It would tug at my conscience and I believe he did the right thing in filing the lawsuit that he did. But to say that this law is taking away religious freedom is giving the law way too much power – a power it has not earned nor deserves. This law is not mandating that the Christian doctors I work with every day prescribe these abortive medications. It is not requiring that I wear a certain type of clothing or head covering, or even bow to a certain idol or person. This law will change absolutely nothing in my personal relationship with Christ. It changes only a line on a Christian’s insurance EOB (explanation of benefits) and what her insurance premiums will pay for. Let us not give undue power to the law of our nation.

2.Paying to Caesar: On June 28, 2012, the U.S. Supreme Court ruled that the Affordable Care Act’s insurance mandate was a “tax.” Well, taxes, in fact, were discussed a great deal in the New Testament. They were a sort of hot topic at the time as well. In Mark 12:13-17, the Pharisees were trying to trap Jesus in his own words and asked him, “Is it right to pay taxes to Caesar or not?” This was a loaded question for that community. Jesus answered to them to, “Give to Caesar what is Caesar’s and to God what is God’s.” The word “Caesar” came with all sorts of baggage – not too unlike the word, “Obama” carries today to some as well. But Tiberius Caesar’s  government was crucifying innocent men, exorbitantly taxing the poor, and offered almost no religious freedom. Tiberius in his personal life was a pedophile, a murderer, and by the very nature of being “Caesar”, claimed to be a god. The denarius Jesus held in his hand was funding this man’s administration. This was the man Jesus said to give what was rightfully his. This story carries more than just a discussion of paying the government taxes. It is much more about giving to God what is God’s! I may pay 25% of my paycheck to a government that supports abortion, instigates drone attacks, and carries out capital punishment…but my allegiance does not belong to my government or to my country – my heart does not beat for the president but it longs for my Savior. Jesus said in Matthew 10:28, “Do not be afraid of those who can kill the body but cannot kill the soul. Rather, be afraid of the One who can destroy both soul and body in hell.” Do I respect our President and love my country? Absolutely. But I do not fear them.

3. Innovate, Don’t Stagnate: Hobby Lobby faces almost certain financial peril should the SCOTUS uphold their decision. Jesus was sending out his disciples in Matthew 10:16 and undoubtedly they were facing significant danger  as well. It was at that time that he warned them to be, “as shrewd as snakes and as innocent as doves.” Synonyms of “shrewd” are, “clever, smart, sharp, astute, and sly”. I truly hope that Mr. Green gets ridiculously creative and lovingly shames those who may impose upon him these regulations. What if David Green boldly switches his business model into a not-for-profit “religious organization” to incorporate abortion prevention services and ministries to those reeling from past abortions. What if he gathered the most creative innovators he could find to stage loving displays of dissidence. This could be Mr. Green’s most challenging yet brightest hour…and even better yet – our Lord would be glorified.

4. Commitment To Conscience: Several years ago, I purchased David Green’s book, More Than a Hobby and was impressed by his commitment to his faith. It’s a good read. I bought the book years before Hobby Lobby was all over the news so I pulled the book off my shelf several days ago to again peruse its pages. What amazed me was that the language we have heard Mr. Green using on all of the media outlets was the very same language he used years ago before his business was faced with near-certain financial ruin if he held to those very same values. Chapter 12 entitled, “This is Not a Secular Business”, could have been taken straight off the front page of today’s newspaper. I have deep admiration for this gentleman. He was committed to following Christ years ago when he was building a brand, and he remains committed to his walk when the road is difficult as well. “Whoever walks in integrity will be delivered, but he who is crooked in his ways will suddenly fall.” Proverbs 28:18.

5. De-Politicize It: The two foes have taken their respective corners and the fighting has begun. The GOP has rallied around Hobby Lobby as they hold high their banner of the “Evangelical Right”. The Left has rallied around the Affordable Care Act and the Obama Administration as they hold high their banner of the “rights of women.” But these divisions only clarify for me even more that God’s Kingdom is not of this world. The Left is blind to the fact that though they are the party of the underdog, they trample on the lives of those most helpless. And the Right is blind to the fact that though they are the champion of the unborn, they often turn away from the poor. I realize that these are over-generalizations. But my point is this: Our hope is not in laws, lobbyists, or lawyers-it is not in our Country or our President-it is not in our freedom from worldly oppression…it is in the Salvation, Grace, and Mercy that our Redeemer has freely given. “Some trust in chariots and some in horses, but we trust in the name of the Lord our God.” Psalm 20:7