DALLAS (BP) — As employers nationwide — including most churches — prepare for 2014, the year that the Patient Protection and Affordable Care Act becomes more broadly implemented, questions are understandably arising from pastors, business administrators and church personnel and finance committees.
O.S. Hawkins, president of GuideStone Financial Resources, said the Southern Baptist entity is intent on maintaining its role as an advocate for church plans in general and for pastors and others in ministry it serves specifically.
“Since the enactment of ObamaCare in 2010, GuideStone has been focused on addressing the impact of this law upon our pastors and others serving churches and ministry-related organizations,” Hawkins said. “In fact, we continue to be at the forefront of advocating for pastors and others in ministry as the impacts of ObamaCare unfold. That remains a top priority here at GuideStone and is a multi-faceted endeavor.”
Pastors and churches must address four main concerns as they look to re-enrollment for 2014:
1. whether they will provide coverage for their employees or put them in a position of having to obtain coverage on secular exchanges.
2. how exchange plan benefits and total cost of coverage, including out-of-pocket expenses, exchange taxes and fees, will compare with their existing coverage.
3. whether, if they use a secular health plan provider, they will be subsidizing objectionable contraceptives, including abortifacients.
4. whether their health plans meet applicable health care reform limits and rules.
Health care exchanges
Under the health care reform law, health care exchanges — or marketplaces — were to be set up in all 50 states. Many states elected not to do so, meaning the federal government must establish them in those states. To date, 24 states have, or are working to, establish state-run or federal-state partnership exchanges. The remainder will have federally run exchanges.
Despite a deadline of Oct. 1, 2013, to establish these exchanges, even at this late date much is unknown. Subsidies available to eligible individuals and families (e.g., those with a taxable household income around $62,000 for a family of two, $94,000 for a family of four, etc.) who seek their coverage through a health plan on an exchange may lower the out-of-pocket and/or premium costs, but the reality is that many exchanges may only offer limited provider networks, including fewer choices of doctors and medical facilities. This means that some individuals who move to exchanges may be forced to move their care from their existing doctor, or they may have limited choices when it comes to evaluating where to have surgery or receive complex treatment.
While many pastors and their families would otherwise qualify for these subsidies, the way the law was written excludes them from accessing subsidies if they participate in a church health plan, such as GuideStone’s. GuideStone views this as an issue of fundamental unfairness.
“GuideStone continues to work diligently with a broad coalition of denominations to help pastors and other ministry workers who want to keep their coverage with church health plans,” Hawkins said. “The Church Health Plan Act of 2013, S.B. 1164, would offer the same premium tax credits available to individuals who get their coverage from secular exchanges to those who can get their coverage from church health plans, like GuideStone’s.
“GuideStone has been instrumental in getting this legislation introduced into the Senate. But this effort is moving slower than it should because both Democrats and Republicans are putting politics over the needs of pastors. We continue to urge legislators to stand up for pastors and pass this important legislation, which will help more than 1 million ministry workers across all denominations.” More information about the Church Health Plan Act is available at www.FairnessForPastors.org.
Health care costs and coverage
“Our participants can rest assured that the quality GuideStone coverage they depend on will continue well past 2014,” Hawkins said. “Much is still uncertain about commercial market and exchange pricing. Some in the industry have speculated that premiums for exchange plans could jump 40-50 percent, which raises understandable concern. In contrast, GuideStone’s average rate increase for 2014 will be in the single digits — and that increase is driven by the burdensome requirements of ObamaCare as well as conditions in the health care marketplace.”
GuideStone’s Church Health Plans meet — and often exceed — the minimum value coverage requirements set forth by health care reform. GuideStone’s plans have long provided comprehensive, quality coverage for participants and already include many of the reforms now mandated by health care reform. For example, GuideStone already was providing coverage with no annual or lifetime limits and GuideStone had never terminated a participant’s coverage for high or frequent claims.
“GuideStone remains committed to actively managing health care costs and providing participants a wide range of cost-effective coverage options in the future,” Hawkins said. “In addition to being competitively priced, they include elements such as capped out-of-pocket maximums that help participants control their overall costs.”
To get a true sense of the cost difference between health plans on the exchanges and their current provider, GuideStone recommends that individuals look beyond base premiums and include out-of-pocket costs such as deductibles, co-pays and co-insurance, as well as weigh the importance of provider networks, which can have a dramatic effect on the cost of accessing care from their existing doctors and facilities.
Abortion-causing drugs (abortifacients)
GuideStone’s Church Health Plans offer health care benefits designed to reflect the biblical convictions of Southern Baptists and other evangelical believers. GuideStone’s Church Health Plans, for example, cover a wide range of FDA-approved birth control options — but they exclude from coverage those that are abortifacient in nature.
“GuideStone was one of the first evangelical organizations to speak out on religious liberty and convictional concerns related to ObamaCare,” Hawkins said. “Even before the government issued its contraceptive coverage mandate, GuideStone was preparing to fight any requirement to cover abortifacients. Through the efforts of GuideStone and others, churches and closely-related denominational organizations were exempted from this objectionable mandate. But we are still fighting the battle to protect other organizations that do not fit in those exempt categories yet share these biblical convictions regarding the sanctity of life, such as colleges and universities and various other ministries. We are exceedingly grateful to be part of a body of believers that sees each and every life as a gift from God.
“There is simply nothing more important than protecting the most vulnerable among us: the unborn. We are pursuing every possible avenue of advocacy in that regard, including formulating a legal challenge in the courts on behalf of those ministry organizations that have not been exempted and may not have the resources to bring actions of their own.
“GuideStone remains committed to its wide range of advocacy endeavors. Together, with our friends at the Ethics & Religious Liberty Commission, we are standing strong for religious liberty and our biblical convictions. At the same time, we are deeply engaged in seeking legislative and regulatory fixes for church health plans so we may protect and preserve coverage that is specially designed for pastors and others in ministry,” Hawkins said.
GuideStone’s health care reform website, www.GuideStone.org/HealthReform, includes additional information about health care reform and churches, including advocacy efforts on behalf of GuideStone participants.
The health care reform law, itself more than 2,000 pages in length, has spawned to date more than 20,000 pages of regulatory guidance. For the most part, the unique needs of churches and other ministry organizations are not addressed. That makes adherence to the law that much more difficult.
For those participating in GuideStone plans, those burdens are greatly mitigated. “We’ve looked for ways to shoulder as much of the burden of ObamaCare for our participants as we can,” Hawkins said. “Those in our plans can know that they’re complying with applicable provisions of the law and that we’re actively advocating on their behalf.
“ObamaCare imposes a number of requirements upon employers with 50 or more employees, and GuideStone has been working closely with those employers to provide assistance and support,” Hawkins said. “However, we also provide the same assistance and support to our smaller employers through a variety of channels, including www.GuideStone.org/HealthReform. Our commitment to the pastor at the crossroads is unwavering, and providing this information online allows us to communicate to the widest possible audience in a timely, cost-effective manner.”
On the health reform website is GuideStone’s PPACA Overview, which is updated as important changes come out and answers some of the most common questions regarding health care reform and its impact. Visit www.GuideStone.org/HealthReform, select “Individuals/Families” and choose “PPACA Overview.”
As re-enrollment materials are mailed out in September and October, GuideStone will continue to update its website with more up-to-date information.
Jennifer Carter & Roy Hayhurst work in the editorial services area at GuideStone Financial Resources of the Southern Baptist Convention. Get Baptist Press headlines and breaking news on Twitter (@BaptistPress), Facebook (Facebook.com/BaptistPress) and in your email (baptistpress.com/SubscribeBP.asp).