Amish exempt from new health care rules

Thousands of Amish residents will see few changes in their health care despite new federal requirements that most people have health insurance.

The landmark health care legislation passed last month will extend coverage to 32 million uninsured Americans. Most people would be required to buy insurance for the first time or face penalties if they refuse.

But a provision in the legislation exempts members of churches that have conscientious objections to private or public insurance. That includes the roughly 239,000 Amish in the United States, many of whom live in the Midwest.

The Amish traditionally don't vote and have a long-established practice of not participating in government-run programs such as Social Security and Medicare.

"They believe the church has the responsibility, actually the divine responsibility, to provide for its own members. In a sense, God is holding them accountable for taking care of their elderly, their disabled, people who might be out of work," said Steven Nolt, a history professor at Goshen College who studies the Amish and Mennonites.

Lawmakers whose states or districts include large Amish populations pushed for the carve-out to ensure the Amish wouldn't be fined for not participating in the new health insurance mandates. The exemption does not extend to the employer mandate, which calls for fines of $2,000 per full-time worker each year starting in 2014 if they don't offer insurance. But most Amish businesses would not be affected because they have fewer than 50 employees.

Herman Bontrager, secretary-treasurer of the National Committee for Amish Religious Freedom, said leaders of the order are waiting to see how the Department of Health and Human Services writes the regulations that will determine how the law is implemented.

Denise Reiling, an associate professor at Eastern Michigan University who also is a cultural liaison with Amish communities in northeast Indiana, said the Amish could benefit if medical costs fall as a result of the health care overhaul. Amish families faced with large medical bills pay what they can, and the church pays the balance.

Anything that would reduce costs, she said, "would be a tremendous boon to Amish people."