Goshen, USA - The new federal requirements requiring most people to have health insurance has left room for the Amish - and other religious groups - to maintain their beliefs when it comes to health care.
The landmark health care legislation passed last month will extend coverage to 32 million uninsured Americans. Most people would be required to buy insurance for the first time or face penalties if they refuse.
But a provision in the legislation exempts members of churches that have conscientious objections to private or public insurance. That includes the roughly 239,000 Amish in the United States, about 40,000 of whom live in Indiana.
The Amish traditionally don't vote and have a long-established practice of not participating in government-run programs such as Social Security and Medicare.
"They believe the church has the responsibility, actually the divine responsibility, to provide for its own members. In a sense, God is holding them accountable for taking care of their elderly, their disabled, people who might be out of work," said Steven Nolt, a history professor at Goshen College who studies the Amish and Mennonites.
Lawmakers whose states or districts include large Amish populations pushed for the carve-out to ensure the Amish wouldn't be fined for not participating in the new health insurance mandates.
The exemption does not extend to the employer mandate, which calls for fines of $2,000 per full-time worker each year starting in 2014 if they don't offer insurance. But most Amish businesses would not be affected because they have fewer than 50 employees.