Are American Muslims exempt from the requirement to purchase health insurance under the individual mandate of the Patient Protection and Affordable Care Act (PPACA)?
There has been a lot of talk, and a number of Internet rumors, to the effect that Muslims are exempt from the PPACA's individual mandate; that Muslims will get free health care under the PPACA, while the non-Muslim population of the United States will be required to purchase government administered health insurance. Therefore, according to rumor, non-Muslim Americans will be paying for American Muslims' health care; in other words "dhimmitude." There is even a rumor that the word "dhimmitude" --used to denote subservience to Islam by non-Muslims, is actually used--on p. 107 of H.R. 3590 of the PPACA bill.
The rumors of free health care for Muslims are based on Shariah law's prohibition on insurance. Insurance violates the tenets against riba (interest); al-maisir (gambling) and al-gharar (uncertainty). Interest paid on insurance investments violates Shariah’s rules against usury. Thus, under a strict interpretation of the Koran, Muslims are exempt from ObamaCare. However, the talk and the rumors are false--the word "dhimmitude" isn't used anywhere in H.R. 3590, and depending on how PPACA rules are applied, there is at least an even chance that the scenario of American Muslims being exempt from the requirement to purchase insurance under the individual mandate won't play out.
To be sure, the PPACA does grant a number of exemptions from the requirement to purchase the "minimum essential coverage." (Whatever that is — Health and Human Service Secretary Kathleen Sebelius hasn't yet defined it.) Prisoners, illegal aliens, and foreign nationals are exempt. In addition, there is a religious exemption. Under Subtitle F, Part I, Section 1501--the individual responsibility requirement to maintain minimum essential coverage--individuals must be "a member of a recognized religious sect" that doesn't participate in Social Security. According to a January 2011 Heritage Foundation WebMemo, they must pay no Social Security taxes and receive none of the benefits, in accordance with Section 1402(g)(1) of the Internal Revenue Code. The religious exemption applies to any person who is a member of a "recognized religious sect or division" with "established tenets or teachings" that would forbid that person from accepting public or private insurance. Thus the Amish, who believe in taking care of their own elderly and don't participate in Social Security, are exempt, as are Mennonites and Scientologists.
The monetary penalty for failure to purchase the "minimum essential coverage" is the larger of a flat dollar amount or a percentage of income between 1.0 and 2.5 percent. The penalty is phased in over a three year period, 2014-2016. The flat dollar amount is $95 in 2014, $325 in 2015, and $695 in 2016. Individuals whose earnings are below the Federal poverty level are eligible for a "hardship" exemption from the penalty, which is determined by HHS Secretary Sebelius. Indian tribes are also exempt from the penalty. In addition, there is an "affordability" exemption that applies to workers whose out-of-pocket costs exceed 8 percent of their “household” income.
Where do American Muslims stand regarding the individual mandate's religious exemption? Under a strict interpretation of the Koran, which forbids acceptance of public or private insurance, they are exempt under this loophole. However, since the great majority of American Muslims pay Social Security taxes and receive Social Security benefits, they don't qualify for the religious exemption. Nevertheless, PPACA rules offer a situation where American Muslims could qualify for the religious exemption. If an individual is a member of a "health-sharing ministry,"--a religious non-profit organization in which members contribute money to cover the medical expenses of those in need--they are exempt from the requirement to purchase insurance.
Health sharing ministries exemplify the Muslim principle of Takaful –individuals cooperating and protecting one another against loss or damage. This writer knows of no such health sharing ministry organizations in the U.S. at present. However, as of December 2008, Risk Specialists Companies, Inc., a subsidiary of AIG Commercial Insurance, has offered Lexington Takaful Solutions SM Takaful homeowners insurance, which includes health insurance. This is part of a series of Shariah-compliant insurance products in the U.S. The Takaful homeowners policy is underwritten by RSC member company A.I. Risk Specialists Insurance, Inc., in conjunction with Lexington Insurance Company, and is available in all 50 states. However, why was this provision--that members of health sharing ministries qualify for the religious exemption--put in H.R. 3590 in the first place? What happens when American Muslims, who participate in the Social Security system, join a "health-sharing ministry"?
The law is vague on this point. Presumably, they will be exempt from the requirement to purchase insurance under the religious exemption. Should this happen, the scenario of American Muslims being exempt from the requirement to purchase insurance, while the great majority of Americans labor under this requirement, will bring "dhimmitude" a big step closer to reality. In addition, what if the PPACA is amended in some way to exempt those who purchase private Takaful health insurance? The health-sharing ministry loophole is one reason, among many, why ObamaCare is unacceptable for Americans and must be removed from H.R. 3590.