High court rejects challenge to federal aid for religious health center

By The Associated Press

04.02.01

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WASHINGTON — The Supreme Court allowed continued federal funding for Christian Science nursing care today.

The court, without comment, turned down an appeal in Children's Health Care is a Legal Duty Inc. v. McMullan, a Minnesota case that claimed Medicare and Medicaid payments to church-run health centers violated the constitutional separation of church and state.

A taxpayer group has tried for years to stop the medical payments, arguing that the church relies on faith healing, not traditional medicine.

The First Church of Christ, Scientist, teaches that prayer is the most effective treatment for illness and that conventional medicine is incompatible with spiritual healing.

Although Christian Science nurses use no drugs or conventional medical treatments, they have received millions of dollars in federal Medicare and Medicaid reimbursements since the mid-1960s.

Church officials say the money pays for general nonmedical care such as bandages and bedpans, but not prayer.

Medicare and Medicaid, which provide health care for the elderly, disabled and poor, ordinarily pay for nonmedical services only as they relate to medical care.

Children's Health Care is a Legal Duty Inc., or CHILD, based in Sioux City, Iowa, won a 1996 court challenge, when a federal judge ruled that the payments were unconstitutional.

At the time, federal law contained an exception allowing coverage for nonmedical care at health care centers operated or certified by the Christian Science church. The exception was intended to allow Christian Scientists who would be eligible for traditional medical care under Medicare or Medicaid to get help without violating their religious principles.

The Justice Department bowed out of an appeal, saying it could not defend the payments as they were then made. Then-Attorney General Janet Reno said one solution might be for Congress to rewrite the law.

Congress did so in 1997. The reworked law allows the payments to "religious nonmedical health care institutions."

CHILD sued anew in a federal court in Minnesota, making much the same constitutional arguments as before. The new law is so carefully and narrowly worded as to apply only to the 23 Christian Science health care centers, called sanatoria, CHILD claimed.

This time, CHILD lost in lower courts. Last year, the 8th U.S. Circuit Court of Appeals ruled that the new arrangement is constitutional. It is "sect-neutral," and neither promotes one religion nor imposes a burden on another, a divided appeals panel ruled.

CHILD appealed to the Supreme Court, arguing that the 1997 law violates the First Amendment's bar against government establishment of religion.

"Tens of millions of Medicare and Medicaid dollars have been paid by the federal government directly into the coffers of the Christian Science Church's sanatoria for the nonmedical care of its members by faith-healers," lawyers for the group wrote in court filings.

The 8th Circuit's "convoluted" reasoning in approving the payments invites constitutional mischief, CHILD said.

"This case requires reversal before the siren song of its reasoning spreads in this era of rapidly replicating government programs yielding aid to religious entities," the group's lawyers wrote.

CHILD pointed to the 1996 "charitable-choice" law that invited religious groups into the competition for government welfare dollars. Although the welfare program has not caught on, President Bush hopes to expand it to social service programs across government.

Bush would allow religious groups to qualify for government money without changing the nature of their programs and without forming secular spin-off organizations.

The Justice Department and the Christian Science church urged the Supreme Court to stay out of the case.

Overturning the 1997 law "would impose extraordinarily harsh consequences on poor and elderly Americans who rely upon nonmedical health care as a matter of religious conscience," the church court filing said.

Christian Scientists pay taxes to support the federal programs but could not benefit from them without accommodation from Congress, the church wrote.