Wednesday night, the battle against the potential repeal of the Affordable Care Act will get an unlikely ally: the clergy. The grassroots advocacy group Rise and Resist is holding a 24-hour vigil to protest the Senate’s still-secret Republican health care bill at New York City’s Columbus Circle. Two of those hours — from 10 pm to midnight on Wednesday — will be devoted to “prayer and testimony” from faith leaders and congregation from a variety of faith traditions.
"We are people shaped by our respect for life and the dignity of each human person, how can we not be at the front lines of health care reform?” wrote pastor Alistair Drummond of West End Presbyterian Church and Laura Jervis, parish associate at Rutgers Presbyterian Church, in a mass email to various faith leaders forwarded to Vox, encouraging colleagues to join the protest. The note quoted from both the Old and New Testaments of the Bible and the Quran.
Much media coverage on the role of faith and health care has focused on religious groups’ opposition to elements of the ACA, also known as Obamacare. Prominent religious figures in the ACA debate have included companies like the Christian-owned Hobby Lobby. Organizations like the Roman Catholic religious order Little Sisters of the Poor objected to the idea that ACA-mandated, employer-sponsored health insurance might cause these organizations to direct funds toward contraception or abortion, or to be complicit in the funneling of governmental funds toward that end. (The Supreme Court ultimately ruled 5-4 in favor of Hobby Lobby and punted the Little Sisters case, Zubik v. Burwell, back to lower courts for consideration).
But in recent months, many representatives of faith communities have become vocal supporters of the ACA or, at the very least, opponents of any political program that would put an undue burden on their congregations. Just last week, at the annual meeting of Catholic bishops in Indianapolis, a number of bishops spoke in opposition to the potential ACA repeal, according to America Magazine. Bishop George Thomas, of Helena, Montana, said, "If left unchallenged or unmodified, this budget will destabilize our own Catholic health care apostolates, take food from the mouths of school-age children and the homebound, and deny already scarce medical resources from the nation’s neediest in every state across the land.”
Several religious leaders Vox spoke to reaffirmed Thomas’s sentiments. "As clergy, while we do not engage directly from the pulpit, we do consistently preach about caring for the poor, the hungry, the refugee, the immigrant, and all of those on the outside of power,” Rev. Elaine Ellis Thomas, associate rector of St. Paul's Memorial Episcopal Church in Charlottesville, Virginia, told Vox. "Caring for basic needs such as health is a gospel imperative.”
She also pointed out the particular threat the ACA repeal might hold for women: "ACA repeal at the same time that Planned Parenthood is under threat can mean no recourse for [women]. The stress over health care, including reproductive health, is high.”
Rabbi Jill Jacobs, executive director of the advocacy organization Tru’ah, told Vox that a similar sense of obligation is vital to the Jewish tradition. "This starts in the Bible, with the insistence that every human being is an infinitely valuable creation in the divine image, and the command therefore not to stand idly by the blood of one's neighbor,” she said. “The Talmud and later ... teachings highlight the importance of doctors, insist on the obligation to save a life if one is able to do so, and that even prohibit selling medicine at too high a price.”
ACA repeal could further pass the responsibility for lower-income members onto the shoulders of faith communities
Many of the religious leaders who spoke to Vox pointed out that the financial and pastoral burden of health care can often falls on a religious community — a burden that may only intensify if the repeal goes through.
“For many people, faith communities represent trusted, accessible community spaces — often far more so than the hospitals and clinics where we practice as physicians,” Dr. Altaf Saadi, a neurology resident at Harvard involved in community organizing and interfaith outreach, told Vox.
Faith communities, therefore, are often on the front lines when it comes to seeing firsthand the necessity of medical care for the needy. As Rev. Carol McVetty, interim executive minister of the American Baptist Churches of Metro Chicago, told Vox, this care can take a variety of forms.
"The congregation I pastored for many years worked hard to give rides to the doctor when needed. Well-established refugees helped newer ones navigate the medical system and translated at doctor appointments. ... Hours and hours of volunteer effort,” McVetty said. “Church members take meals to the sick and visit in the hospital. We often host or conduct health education events (wellness, cancer awareness, etc.) But prayer, pastoral care, and loving friends can't replace medical care” — especially when that care costs money.
McVetty also pointed out that in many smaller Christian communities, pastors themselves are often beneficiaries of ACA subsidies: "The ACA was an enormous boon to our pastors. Many of them currently get their health insurance from Illinois's ACA marketplaces. The churches can't afford employer-provided insurance, and pastors' salaries are low enough that many would be receiving some subsidy to help pay for it” — a subsidy she does not necessarily trust a Trumpcare plan to maintain.
Complicating the issue further is the undue strain many religious communities will face, as demand for financial help for needy members will likely rise after repeal. In some Jewish communities, the gemach — a community-administered, interest-free loan — proliferated beyond its roots in more insular Orthodox communities in the aftermath of the 2008 financial crisis. The repeal of the ACA may intensify that need further.
As Laura Turner reported in an excellent BuzzFeed article, Christian communities have often turned to health care sharing ministries, a religiously motivated alternative to traditional insurance structures, which work by pooling and redistributing the monthly contributions of members, and which are not bound by legal regulations about preexisting conditions or other forms of membership discrimination. (A loophole in the ACA allows members of such ministries, which often cost less than traditional insurance plans, to be exempt from the individual mandate.)
But as Turner points out in her piece, these community structures can often prove tricky for members to navigate, particularly if medical needs conflict with religious maxims. For example, in addition to not covering medical expenses relating to birth control or abortion, many do not cover expenses relating to self-injury or self-harm.
"On their face, these ministries are much more affordable than traditional insurance, but there are hidden costs, like caps on how much can be shared per incident and lack of sharing for preexisting conditions,” Turner told Vox. “Religious communities can and do unite in this way in partial fulfillment of the biblical command to ‘bear one another's burdens,’ but they have a long way to go before all burdens are shared.”
Wednesday night’s protest by faith leaders in New York may do little to change the outcome of the ACA repeal efforts. But it’s worth noting that in today’s climate, the GOP’s commitment to courting religious voters might hinge on more than just the traditional “hot-button” issues of LGBTQ rights and abortion. For many leaders from a variety of religious communities, access to health care is a religious issue as well.