Why Christians should be OK with the Supreme Court’s health-care call

Within hours of the announcement of the Supreme Court’s decision in favor of the Affordable Care Act, my e-mail had filled with commentary and questions from friends, colleagues, students and citizens around the nation all asking the same thing: “What now? How should we think about this?”

Pundits are talking non-stop about what this decision means for the Supreme Court, the upcoming election and the finances of already-strapped state governments. These are important issues, but for Christians busy with their everyday lives who want to be faithful citizens yet do not live for politics, what does this decision mean?

I think Christians, no matter what their politics, should be OK with this Supreme Court decision and we should resist the temptation to make this the lynchpin on which we base our upcoming election decisions.

The good thing about American politics is that nothing is ever a done deal. This court decision is complex, but its most simple communication is that the federal government has the right to tax. Under this analysis, the national health care program as defined by the Affordable Care Act is constitutional. We are at the beginning of what is going to be years of discussion about how we think about health care. Here are some things that we have to keep in mind as we continue to talk about how we take care of the sick.

First, Christians are clearly directed by both the Old and New Testaments to put the care of the sick and the poor at the top of their concerns. If we believe that God is sovereign over all of life we have to accept the challenge that our concern for the sick and the poor is an individual concern and it is a concern of government, churches and businesses. The interplay of these different responsibilities can be difficult to figure out. Democrats tend to stress the responsibility of government; Republicans tend to stress the responsibility of the church. But all of these institutions are responsive to God and all of them have an obligation in this area.

Second, those that advocate for a national program are not communists and those that advocate for less government oversight, or oversight at the state level, are not abandoning the poor. However, our state programs have not stepped up to the plate in helping the uninsured get coverage. In good economic times, states like Washington did a good job of covering the working poor in a state health insurance program. As soon as times got tough, though, the program was reduced. All states are facing very difficult economic realities. At this point the federal government’s requirements are the only way those most in need are going to be covered. And, when we look at other countries around the world we see that our situation is quite typical. The United States is one of only a few developed countries that has not had universal health coverage shaped by a system of legislation, regulations and taxes. While the U.S. medical system is excellent for those with resources, those with fewer resources suffer greatly. Our life expectancy ranks us around 50th in the world. Our infant mortality rate is high (6.7 deaths per 1000 live births), ranking us 29th. This isn’t because we can’t care for our citizens but because we don’t. 

Third, much of the national program still has to be implemented, especially at the state level, and Christians should be prepared to think through difficult questions. Smaller businesses will have a harder time complying with the law, so states might want to further increase tax and other incentives to encourage them. Individual states have to decide if they will increase Medicaid coverage in order to receive more federal funding. Nationally, we also to be attentive to the religious freedom arguments of institutions that say coverage of certain drugs or procedures violate their conscience.

Universal health care will continue to be debated. It isn’t a panacea but is also isn’t an outrage. As long as we keep our responsibility to care for those in need front and center, there are many ways to achieve just policy. 

What Do You Think?

  • Where do you find your information when trying to learn about the Affordable Care Act?
  • From your understanding, how does the act support a Christian approach to just health care and how does it restrict such an approach?
  • What influence should Supreme Court decisions have on Christians?


Comments (10)

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To think or not to think..that is the question?  This article clearly enumerates some points to consider while allowing that all Christians are not only Republican partisans.  The idea that conservatives believe that all poor people are slugs or heathen has always made me uncomfortable. That appears the general way Christians are portrayed. Thanks for this article that allows for thought about our multiple concerns in a kingdom that is not ours.

Julia, I really appreciate your observation that not everyone on one side is ogreish nor are those on the other simpletons (or whatever labels someone is trying to slap onto their opponents).

I also like how you pointed out that the Court merely said the Constitution allows the feds to tax and that this statute functions as a tax so it’s constitutional. A set of statements I heard yesterday on the radio reflect an unfortunate and profound misunderstanding of what the Supreme Court did. One person was quoted as saying it was wonderful that the Court stood up to protect those unable to protect themselves. Another person said it was horrible that the Court completely disrespected both the rights of States and of individuals regarding health care issues.

What a load of rubbish. The Supreme Court’s job has nothing to do with standing up to protect anyone, nor to worry about showing respect or disrespect toward one contingent or another. In a case like this its job is to look at a law, look at the constitution, and if they square up the ruling goes one way and if not it goes the other.

I remember hearing a case years ago that had to do with a challenge to the construction of a minor league baseball stadium. It was very politically charged. All I had to do, though, was determine whether the government had followed the proper procedures in approving the stadium’s construction. They did and I ruled accordingly. Someone saw me at church a couple days later and said, “Wow, you must really be a baseball fan!” He was serious and thought that played a part in my ruling. As I said above, what rubbish.

Good job, Julia.


I was curious about your thoughts on this ruling, Tim. I’m sure this isn’t all of them, but it is helpful. Thanks.

This issue is so complicated; it seems far above my pay grade (even with a few degrees).

I appreciate analyses that offer a big picture view. Thank you.

“Democrats tend to stress the responsibility of government…”

As a card-carrying Democrat, I wouldn’t necessarily say that’s true for me or for my fellow Democrats.

My view is that God has given basic responsibilities to *society*—to ensure that the powerful aren’t given the ability to oppress the powerless, to make sure the poor and vulnerable have their needs met, to give everyone the opportunity to contribute to the common good and provide for their families and themselves.

Because government is the only institution accountable to all of society, present throughout the nation, and possessed of the power to make sure everyone pays their fair share, government is the ideal primary means of fulfilling those responsibilities.

Other institutions, like churches, businesses, nonprofits, and families, have a role to play in fulfilling those responsibilities, but government is the only institution with the reach and power to be in a primary role of responsibility. Churches can’t force the rich to pay their fair share, businesses are accountable only to their shareholders, and none of those three institutions has the kind of societal reach or capacity to ensure that everyone’s covered.

But the responsibility isn’t the *government’s*; it’s the *society’s,* with government as society’s best means towards fulfilling its responsibilities. Our government is of the people, for the people, and by the people; *we,* all of us, bear responsibility for our government.

I work in healthcare.  The fact is that the vast majority of the problems in healthcare today are the direct result of Messianic attempts by the government to “care for the sick.”  That is what Obamacare is - an attempt to fix problems caused by previous government interventions.  So if you truly care about the sick, would you use something that has failed repeatedly in the past to achieve the results you desire?  What’s that thing about, “first, do no harm?”

I don’t think belief in the government as the best means of fulfilling society’s responsibilities qualifies as Christian.  Jesus said, “my kingdom is not of this world” and became the foundation of the Christian church.  If he intended for the church to fill a certain role, we cannot expect the government to fill that role and still believe that we are fulfilling our Christian duties.

The presumption there is that “church” and “society” are the same thing, such that the church would have the capacity to fulfill the responsibilities of the whole of society.

That’s why, as I mentioned above, I think government is a better vehicle for ensuring that society fulfills its responsibility. If the church were to take on all of the responsibilities God demands of the whole of society, in our pluralist nation, then people could shirk their responsibilities to society simply by opting out of the church.

In such a system, the church could never develop the kind of capacity that government even currently has, in a situation where we’re falling far short of God’s demands for society. I’ve yet to see it demonstrated that churches would have that kind of capacity to serve all people equally were we to eliminate government from its role fulfilling what God considers society’s responsibilities.

The only way to give the church that kind of capacity would be to give the church coercive power, thus making church and society the same thing—to essentially replace our democratic republic with a theonomy in which all were expected to contribute to the church’s work. That is unacceptable to me, and I’d wager it would be unacceptable to most Americans.

I must say that is one of the most rational, well-thought out and considerate responses I have yet to see regarding this issue (and many, many others) in a long time.  I wrestle daily with the “if you aren’t with us you are against us” mentality in conservative politics. The extremists on the right constantly beat the drum about their adherence to the Christian ethic, but I fail to see how railing about helping those who need help the most is very Christianlike.  Likewise, those on the extreme left need to understand that while we need to consider government assistance to the poor and infirm, there is a big difference between a handout and a hand up.  We should be helping those who need it, we should be educating people in how to end dependence, and we should strive to include more cooperative dialogue in politics rather than this endless and nonsensical bickering.  Thanks for your article - I plan to share it.

Very good article pointing out the nuances of the ruling.  The plan has been touted as promising a wide range of solutions:  no pre-existing, no fee for preventative services and of course allowing children to stay on their parents policy until they are 26.  What has been left out of the discussion is who will pay for these benefits.  In the instance of children on their parents policy, the answer is the parents pay for it in the way of income taxes because the benefit is counted as income.  The law high good intentions.  It was simply written poorly and needs to be reviewed.  However, the president is claiming a victory (albeit a hallow one) and will not modify it.  This issue will be a great fundraiser for both sides of the argument but will not be the chief issue of the election.

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