New Budget Allows Federal Aid for Care at Religious Facilities

Patients at qualifying religious nursing facilities that offer nonmedical health care will be eligible for Medicare and Medicaid benefits under a provision in the budget bill President Clinton plans to sign Tuesday.

A federal court in Minnesota ruled last year that the payment of benefits to Christian Science nursing facilities was unconstitutional. Judge Richard Kyle held that the wording of Medicare and Medicaid provisions that allowed such payments was sect-specific in violation of the Establishment Clause of the First Amendment.

The case is currently before the US Court of Appeals but proceedings were stayed when members of Congress and the Justice Department asked the court for time to permit Congress to enact legislation that did not apply only to one religious group.

The newly enacted budget bill amends the Medicare and Medicaid programs to allow coverage for care at what it calls a "religious nonmedical health-care institution." Rather than singling out Christian Scientists, the law covers any patients "who choose to rely solely upon a religious method of healing and for whom the acceptance of medical health services would be inconsistent with their religious beliefs." Reimbursement is limited to nonmedical nursing services and related supplies.

Christian Scientists rely on prayer for healing, rather than drugs and medical technology. When Congress passed the original Medicare and Medicaid bills in 1965, they allowed Christian Scientists to receive reimbursement for room, board, supplies, and nonmedical nursing care at Christian Science nursing facilities.

The work of Christian Science practitioners, which consists solely of prayer, was not covered and will not be paid for under the new bill.

The government estimates that reimbursements to Christian Scientists amounted to $7.4 million in 1992 compared to total Medicare and Medicaid reimbursements that year of $220 billion.

Members of the House-Senate conference committee say the changes in the new budget legislation remove the sect-specific concern identified by Judge Kyle.

THE conference report says the committee "is satisfied that the conference agreement comports with the First Amendment, and indeed that it serves the interest of religious freedom.

"The conference agreement does not provide unconstitutional benefits to religion. Rather, it avoids the unfairness of requiring those Americans to pay taxes, including payroll taxes to the Medicare Trust Fund, for years without being able to receive any benefits."