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Exemptions from the Affordable Care Act includes millions in bill-sharing groups

When she was eight weeks old, Ashlyn Whitney suffered a severe respiratory-tract infection that put her in an intensive care unit for 12 days.

“Because she was so young, she couldn’t handle it,” Ashlyn’s mother, Nicole Whitney, recalled. “They had to give her oxygen.”

The baby, now a year old, recovered from her illness, known as respiratory syncytial virus.The bill for her treatment at the West Boca Medical Center in Palm Beach County came to about $100,000 — a sum that included almost $4,000 in fees for her birth and pre- and post-natal care — but every dime of the tab was picked up by a medical bill-sharing organization set up for its Christian membership.

Such religious groups are exempt from the Affordable Care Act’s mandate that most Americans obtain health insurance or pay a penalty. Although as many as 30 million Americans will remain without health insurance by 2016, despite the best efforts of the ACA’s proponents, all but about seven million of them will be spared having to join the new system because of exemptions created by the act itself, according to an analysis by the Congressional Budget Office and the staff of the Joint Committee on Taxation.

The exempted religious organizations generally pool their members’ money to pay the medical expenses of anyone in the group who gets sick, injured or becomes pregnant. Also exempted from the law are members of federally recognized religious sects who have religious objections to insurance or to such systems as Social Security or Medicare.

Most of the other 20 exemptions address circumstantial situations such as homelessness, eviction, foreclosure, bankruptcy, the death of a close family member or an experience with domestic violence. Members of Native American tribes are also free to not sign up for health insurance, as are those whose income is too low or who are serving a prison sentence.

The organization that Nicole Whitney and her husband, Jonathan, joined two years ago was Medi-Share, a program set up in 1993 by the Melbourne-based, not-for-profit Christian Care Ministry, which says on its website that its members “make the rules — and their dollars don’t support unbiblical choices such as abortion, or drug or alcohol abuse.” More from Nick Madigan here.