Ed Kilgore has a good catch at his blog today: it seems that a number of churches have been asking for a fix to the Affordable Care Act. So far, they’ve been getting a receptive hearing from Democrats on Capitol Hill—but not Republicans. Here’s the nub of the problem they’re trying to solve:
Without the requested “fix,” as many as one million clergy members and church employees now enrolled in church-sponsored health plans could soon face the choice of leaving these plans (designed to meet their unique needs, such as the frequent reassignment of clergy across state lines) or losing access to the tax subsidies provided by the ACA to help lower-to-middle income Americans purchase insurance.
Observers generally agree that the exclusion of church health plans from eligibility for the exchanges, which occurred because they do not sell policies to the general public, was an oversight caused by staffers scrambling to draft bill language under tight deadlines. Because employees of religious institutions are usually paid modestly, many will qualify for subsidies made available on a sliding scale to families earning up to 400 percent of the federal poverty level. But the subsidies can only be used to purchase insurance from the exchanges. …
Without the “fix,” [a representative of the Southern Baptist Convention] said, clergy would be “forced out” of church plans to access the benefits they would otherwise be entitled to receive under the law. And that in turn could threaten the viability of the plans themselves. Among the supporters of the Pryor-Coons effort are the Southern Baptist Convention, the United Methodist Church, the Episcopal Church, and the Presbyterian Church. The legislation also enjoys the backing of the Church Alliance, a coalition of religious organizations represented by the firm K&L Gates.
I can confirm the problem, from both professional and (doleful) personal experience. One Board of Pensions member for the Presbyterian Church (USA) recently estimated that dues paid to his board for health insurance “amounted to just 8 percent of effective salary” in the 1980s. “Now they come to 21 percent, and that’s still not enough to cover expenses.” Church programs tend to be expensive because they’re small, and because the people they cover are typically older than average. (Clergy as a whole are older than most professionals, and church programs also cover retirees.)
Spiraling health-care costs can put quite a bit of pressure on churches, particularly small congregations. A large part of the reason I wound up getting laid off from my last congregation was that they couldn’t meet the quarterly insurance premium. We might have been able to negotiate a salary reduction, but there was just no way to work things out if they couldn’t provide the insurance. So it goes.
It may be that these denominations are interested in the fix precisely because many of their congregations are on the small side. Getting it might mean the difference in keeping those churches viable.
Kilgore is interested to see if Republicans will be able to overcome their fevered desire to sink the ACA in order to implement what ought to be a commonsense fix to a legislative oversight. You’d think they’d be in a hurry to respond to religious groups, particularly conservative ones like the SBC, but so far, nothing. Maybe that will change as religious leaders start to lobby Congress. On the other hand, it might not. I notice two influential groups missing from the list of supporters for the fix: non-denominational evangelicals, whose churches might be self-insured or find other ways to insure their pastors, and the Catholic Church, whose diocesan plans might be large enough not to be affected by the problem. Both groups, it’s worth noting, are heavily set against the ACA.
We may yet see the GOP pinned dramatically between religious constituents and anti-ACA fervor, but if it doesn’t shape up that way, it might be the law doesn’t affect all churches in the same way. The fight’s worth keeping an eye on, though. Republicans are already riding the knife’s edge of demographic change; I can’t see that they have much room to give on religious support.