In Seven-Sky v. Holder, the plaintiff complained that they had religious objections to the individual mandate. The DC Circuit Court of Appeals rejected that argument as well:
The harms appellants allege–the cost of purchasing health insurance from private companies, and violation of their religious belief that insurance expresses skepticism in God’s ability to provide–exist as a result of the mandate, not the penalty. (Silberman, at 15)
You might read this entire opinion and miss the very brief mention of the significant religious exceptions in the individual mandate – a religious conscience exception and exemptions for health care sharing ministries. As Sam Grover (BU Law ’12) explains in a recent AJLM paper (ungated at SSRN). The religious conscience exception:
applies to anyone who is “a member of a recognized religious sect or division thereof described in § 1402(g)(1),” [limited to] (1) sects that “make provision[s] for their dependent members which [are] reasonable in view of their general level of living,” and (2) sects that have “been in existence at all times since December 31, 1950.”
Think of Catholic religious orders with a vow of poverty. What are health care sharing ministries? Glad you asked:
these ministries are groups of like-minded, religious individuals who agree to help pay for each others’ medical expenses, thus avoiding the religious objection that some have to mandatory health insurance.
Think of voluntary groups of evangelical Christians who donate to cover each other’s medical bills, with no legal compulsion.
Grover critically examines these religious exemptions in some detail (28 pages), so you know where to go if you want more.