The Rev. Jeff Tindall of Carnegie Presbyterian Church said he has agonized with parishioners who have needed health care and couldn't get it.
Some couldn't afford it, others lost a job that included health care benefits, still others were denied coverage due to the now-banned practice of insurers refusing to cover pre-existing medical conditions.
So on a recent snowy Sunday morning, Rev. Tindall yielded his pulpit for a couple of minutes to Shannon McGee of the Allegheny Intermediate Unit -- a branch of the Pennsylvania Department of Education -- which has been helping educate local residents about how to enroll for coverage under the Affordable Care Act.
"It breaks my heart to see people who need health care and cannot get it and know that there is virtually nothing I can do for them but pray," said Rev. Tindall. But, he said, "Simply praying for someone is not enough. When opportunities are present where we can help people obtain the help they need, we should bring it to them."
Faith-based organizations have become important players in the implementation of the Affordable Care Act. Though lesser-known than such official roles as "navigators" and "certified applicant counselors," they've been hosting speakers and alerting people who may not follow or trust other sources of information, letting them know that they can get enrolled and where to get help.
"The opportunity we have to get folks who have not had insurance -- or even the hope of getting insurance -- simply enrolled is absolutely central to how I define myself in my faith tradition following a Christ who came as a healer," said the Rev. Sally Jo Snyder, a United Methodist minister working with the Consumer Health Coalition.
Religious groups large and small are hosting speakers and putting people in touch with those who can help with enrollment.
At Carnegie Presbyterian, Ms. McGee talked with individuals, set up appointments and referred them to navigators.
"I was excited that there was a minister who was concerned about his congregation and wanted to provide assistance," she said.
And in some cases, those getting the help are the religious leaders themselves.
The Rev. Mary Ann Strader, executive pastor at the small nondenominational church, Kingdom Life Fellowship, had tried to enroll online in October but ran up against the roadblocks that plagued the early days of the HealthCare.gov website.
Her church hosted a representative late last year from Enroll America. That organization is trying to get people signed up for health coverage. The representative spoke during the service, talked to individuals afterward and followed up with an email, letting people know of an informational session at a local library branch.
There, Rev. Strader got the help she needed to obtain health insurance for the first time since the 1990s.
"It helped our people. It helped me," said Rev. Strader -- who had gone without insurance partly due to its cost and partly due to a spiritual decision to rely on God for her health. She signed up after the ACA made it mandatory.
Divergent religious views
When religion and the ACA come up, it's usually in the context of opposition.
Religious-affiliated organizations -- such as the Roman Catholic dioceses of Pittsburgh and Erie and the Christian-affiliated Geneva College in Beaver Falls -- have filed well-publicized lawsuits to block the mandate that employees get coverage for contraceptives. They contend some of these methods can be abortion-causing, such as emergency contraceptive pills, although medical research has cast doubt on this.
And faith plays a strong role in what people think of the ACA in general, according to a 2013 survey by the Public Religion Research Institute.
Those most likely to want to repeal the ACA are white Protestants -- the backbone constituency of the Republican Party, which has portrayed Obamacare as a power grab by big government. Most wanting to preserve the ACA are populations largely in the Democratic coalition -- including black Protestants and the non-religious. Catholics -- whose leaders have favored broader health coverage, but not for contraception -- are split.
The voices of those who oppose the law from a religious perspective seem to "carry the day in the media," said the Rev. Frederick White, senior pastor at Kingdom Life Fellowship, which meets at the Clarion Hotel in Green Tree. "It doesn't really represent the total of Christianity and it certainly doesn't represent our congregation or most ministers that are dealing with inner-city congregations."
Rev. Snyder agreed.
Her coalition is also trying to enlist religious leaders to call for Gov. Tom Corbett to approve an expansion of Medicaid eligibility under the act. He has proposed an alternative expansion that would allow Medicaid funds to provide private insurance for those who would be eligible for the expansion, while paring down existing Medicaid benefits.
"I would like to think the faith groups would rise up and push the current administration toward expanding Medicaid," Rev. Snyder said. "It impacts the people we are supposed to be identifying with."
Other clergy also called for advocating for expanded access to health care.
"People of faith have to be publicly visible," said Rabbi James Gibson of Temple Sinai, which recently hosted a Pray for Pennsylvania forum with Christian and Buddhist clergy in conjunction with the group Enroll America, a coalition of health-care sector organizations promoting the implementation of the ACA. "Where we choose to be, where we choose not to be" are crucial in setting priorities, he said.
Covering the vulnerable
Among those encouraged by the effort at Carnegie Presbyterian Church was Gina May of Bridgeville. She had gone to the hospital earlier in 2013 with gall bladder problems and was referred to a surgeon to have it removed. But "as soon as they found out I didn't have insurance, they said there was nothing they could do."
So she had two more trips to the emergency room, "The third time it was so bad, I hadn't eaten in four days," she said. "They finally admitted me" and did the surgery. But her lack of coverage meant a longer and more painful wait for it.
At Mount Ararat Baptist Church in Larimer, more than 5,000 attendees saw a recent video presentation on the ACA, with many meeting afterward with representatives of SEIU Healthcare Pennsylvania, the health-care arm of the Service Employees International Union, to learn more about enrolling.
The Jewish Healthcare Foundation, working with several other local foundations, has provided a series of mini-grants to neighborhood and other grass-roots groups to educate people about the act and help them enroll. They include faith-based groups such as Macedonia Family & Community Enrichment Center and Center of Life Hazelwood.
The launch of the ACA is "what we consider a moment in time, a real game-changer for people who never had access to health insurance," said Nancy D. Zionts, chief operating and program officer for the Jewish Healthcare Foundation. Several of these groups are "much more trusted" among their local constituents than larger organizations, she said.
Catholic Charities' Free Health Care Center, where a mostly volunteer corps provides medical and dental care to those not eligible for it under other programs, is also providing information and referrals for people seeking to enroll. The center will continue to help those who can't afford insurance but earn too much to qualify for Medicaid or other subsidies.
While the center's affiliate, the Diocese of Pittsburgh, has obtained a court injunction against cooperating in providing contraception coverage, that doesn't conflict with the broader goal of getting insurance to people without it, said Annette Fetchko, the center's administrator.
"Our mission is to be able to keep our doors open to serve that most vulnerable population," Ms. Fetchko said. "Then we partner with those community organizations" providing help enrolling.
Peter Smith: firstname.lastname@example.org or 412-263-1416; Twitter @PG_PeterSmith.