EACH is an acronym for the Equitable Access to Care and Health Act now before Congress. Who would be against everyone having equal access to care and health? Indeed, the House bill, HR1814, had 225 co-sponsors and was passed under suspension of the rules by voice vote. The Senate bill, S.862, has 32 cosponsors including Sen. Rand Paul.
The bill exempts everyone with sincere religious beliefs against medical care from the mandate to purchase health insurance. Parents with religious beliefs against medical care will not have to get health insurance for their children.
How does depriving a child of health insurance give him equal access to health care, you might ask? To the Christian Science church, which promoted the EACH bills, it makes perfect sense. The church believes it has a health care system that should be a legal substitute for medical care of sick children. If parents don’t have to spend money on health insurance, they will have more money to pay for spiritual treatments by Christian Science practitioners.
There is, however, no data to indicate that spiritual treatment heals diseases of children. Our organization, Children’s Healthcare Is a Legal Duty (CHILD), has information on hundreds of American children who have died because of their family’s religious objections to medical care. There are, for example, 177 minor children and stillborns buried in one cemetery used by Idaho religious objectors; 30 percent of the graves in the cemetery are of minor children and stillborns.
Many other children get to the emergency room at the last minute, and their medical care is much more expensive than it would have been if the children had a medical home and routine basic care.
We feel that at least some of the religious objectors would have gotten timely medical care for their children if they had been required to have health insurance for them. The EACH Act increases the risk to children in faith-healing sects and the cost to the state if the children do get medical care.
The Congressional Budget Office estimates that the EACH act will result in 500,000 additional uninsured people each year and cost taxpayers $1.5 billion over 10 years.
Fraudulent use of the exemption is easy to predict. All an exemptor has to do is say he has sincere religious beliefs against medical care. The Internal Revenue Service is not allowed to inquire into taxpayers’ religious beliefs.
If the religious objector gets “voluntary” medical care, he forfeits the exemption, but it will be difficult for the IRS to learn of it. The cost to the public of the objector’s medical care may be far higher than what the IRS can recoup from him. Also, the objector can get “involuntary” medical care at the public’s expense without affecting his exemption. And even if the IRS determines that the person forfeited the exemption in a given year, the objector can always claim the exemption for the next year.
Massachusetts, where the Christian Science church has its headquarters, allows a religious exemption from purchasing health insurance. In 2007, about 9,700 Massachusetts residents claimed a religious exemption from the mandate. A data match done that year showed that 745 of them had nevertheless received medical care during the year at the public’s expense.
The next data match was not done until 2012. It found that 536 Massachusetts religious exemptors had filed claims for medical care that year to the Health Safety Net, a publicly funded program. Their claims totaled more than $1.5 million.
Though state law prescribes a penalty to them, a Department of Revenue official has told us that the state does not enforce the penalty on religious exemptors who get medical care. And indeed a financial penalty is a perverse disincentive for the religious objector who might think he should take his child to a doctor.
The Massachusetts Inspector General reports that it will be difficult and costly to eliminate the misuse of the religious exemption.
Federal law does give the Amish an exemption from government insurance programs, but the Amish generally get medical care for their children. They have a long tradition of the whole community helping to pay a member’s medical bills. Furthermore, that exemption is strictly confined to their church members and is easy to enforce while EACH allows everyone to self-select the exemption.
The Supreme Court held that the Affordable Care Act individual mandate is a tax. EACH proponents argue that they should not have to pay for services against their religious beliefs. But millions of Americans pay taxes that fund activities we have religious beliefs against.
We call upon Congress to require that parents obtain health insurance for their children regardless of their religious beliefs and to give their bill a more honest title. People do not obtain “equitable” health care by going without health insurance and having 500,000 more uninsured people in this country is not “equitable” to the rest of us.
Rita Swan is president of Children’s Healthcare Is a Legal Duty, a national membership organization headquartered in Lexington.