Satyagraha

Cultural Psychology

Religious Exemption from the Individual Health Insurance Mandate

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In view of today’s Supreme Court decision upholding the individual health insurance mandate, I’d like to make a few brief comments on certain legal, religious, and moral implications.

As the law now stands, (1) citizens may opt out of buying into the national health insurance system based on a religious conscience exemption; but (2) only members of certain state-recognized religions, like Christian Science, can apply the exemption.  This is a huge problem.  The federal government has no business telling us what is and what isn’t religious conscience.  If someone, unconnected with an established religion, were to decide, based on honest and informed examination of conscience, that buying into a national health insurance plan is immoral, then he or she should have the same right to exemption as a Christian Scientist.  This principle – which affirms the conscience of the individual – is explicitly stated in Article 18 of the Universal Declaration of Human Rights:

Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.

The operative words here are “either alone or in community”, with emphasis on “alone”:  you don’t have to be a member of any specific church to have a conscience, or to have the right to act on that conscience.

It is entirely possible that a person’s moral reasoning may following along these lines:

1. At least half of all health problems are the result of wrong moral choices (overeating, intemperance, risky practices, etc.).

2. When bad health is the result of wrong moral choices, the ensuing pain and inconvenience motivates one to improve morally (or to not make moral errors in the first place).

3. If medical treatment is too inexpensive, it reduces motivation to avoid or minimize the immoral choices that produce sickness.

4. To force other people to subsidize a system that, in a sense, encourages immoral/unhealthy life choices is unethical: it forces the moral people to be complicit in a system that hurts others.

5.  Moreover, it is basically unjust to require one person to pay for the consequences of someone else’s wrong moral choices.

6. Further, the entire health industry today is a Tower of Babble – a vast, corporate-run system that subordinates human welfare to profits and materialistic values.  By marrying this monstrous system to the federal government, it threatens to make things worse, and also more difficult to change.

An individual could therefore potentially conclude that he or she has a moral duty – to others, to oneself, and to society – to opt out of the national health insurance plan.

Where does this leave us?

We’ll have to see what happens in the coming weeks.  But it appears there will be an important opportunity here for philosophers, moralists, theologians and civil libertarians.  The first three groups need to flesh out the basic argument sketched above concerning the link between physical health and health of the soul, and the moral implications.   I would suggest that this argument is fully consistent with Greco-Roman philosophy (e.g. Stoic and Natural Law ethics), as well as traditional religious (Christian, Jewish, Buddhist etc.) thinking.  Civil libertarians will have to tackle the problem of the federal government presuming to require affiliation with pre-designated religious organizations as grounds for a religious conscience exemption.

p.s.  Here is the law relating to religious exemption from the Patient Protection and Affordable Care Act (PPACA):

RELIGIOUS CONSCIENCE EXEMPTION — Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.

and here is section 1402(g)(1) of the IRS tax code:

(g) Members of certain religious faiths

(1) Exemption

Any individual may file an application (in such form and manner, and with such official, as may be prescribed by regulations under this chapter) for an exemption from the tax imposed by this chapter if he is a member of a recognized religious sect or division thereof and is an adherent of established tenets or teachings of such sect or division by reason of which he is conscientiously opposed to acceptance of the benefits of any private or public insurance 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 (including the benefits of any insurance system established by the Social Security Act). Such exemption may be granted only if the application contains or is accompanied by -

(A) such evidence of such individual’s membership in, and adherence to the tenets or teachings of, the sect or division thereof as the Secretary may require for purposes of determining such individual’s compliance with the preceding sentence, and

(B) his waiver of all benefits and other payments under titles II and XVIII of the Social Security Act on the basis of his wages and self-employment income as well as all such benefits and other payments to him on the basis of the wages and self-employment income of any other person, and only if the Commissioner of Social Security finds that -

(C) such sect or division thereof has the established tenets or teachings referred to in the preceding sentence,

(D) it is the practice, and has been for a period of time which he deems to be substantial, for members of such sect or division thereof to make provision for their dependent members which in his judgment is reasonable in view of their general level of living, and

(E) such sect or division thereof has been in existence at all times since December 31, 1950.

An exemption may not be granted to any individual if any benefit

or other payment referred to in subparagraph (B) became payable (or, but for section 203 or 222(b) of the Social Security Act, would have become payable) at or before the time of the filing of such waiver.

 

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