Although the Amish have legally opted out of participating in the Affordable Care Act, the religious sect has a sophisticated manner of financing healthcare services for its people, Reuters reported.
Various Amish communities have negotiated prices with local hospitals for its members in exchange for quick cash payments. The communities then use a combination of church aid and benefit auctions to raise money for any member who is unable to pay their bill, according to Reuters.
"We have our own healthcare," an anonymous Amish community member told Reuters. "They [hospitals] give you a bill," he said. "If you can't pay it, your church will."
Many Amish also carry special cards that notify area hospitals they qualify for a discount, Reuters said. Some also formally self-insure, according to the Delaware Health Association.
"It might be multiple funds but the typical format is that they'll pay a monthly fee into that fund and they really treat illnesses and the necessity for medical procedures as a community responsibility," Delaware Health President Wayne Smith told WBOC News.
The Amish, as part of their religious beliefs, have not paid into Social Security, Medicare and Medicaid since federal law exempted them from doing so in the 1960s. That exemption also applies to the Affordable Care Act.
Most Amish communities are located in Pennsylvania, Ohio and Indiana. It is unknown how much local hospitals receive from them to provide care, but at least one hospital executive is not complaining.
"The way they come together to pay for healthcare is amazing," Jan Bergen, chief operating officer at Lancaster General Health, told Reuters."Their sense of responsibility extends beyond themselves and to the community."
There has been occasional friction with authorities and the Amish regarding healthcare regulation, particularly the group's use of lay midwives in Pennsylvania, where licensure is required.
Reuters noted that while Amish do have more genetic disorders than the population as a whole, their lifetimes performing manual labor means they suffer far less from costly chronic conditions such as diabetes.
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