In
Stinemetz v. Kansas Health Policy Authority, (KS App., May 4, 2011), a Kansas state appellate court held that the Kansas agency administering the state's Medicaid program violated the free exercise rights of a Jehovah's Witness when it refused, for lack of medical necessity, to authorize coverage of an out-of-state liver transplant using a method that does not involve blood transfusions. Jehovah's Witnesses object on religious grounds to transfusions. The bloodless technique, not available in Kansas, is less expensive that an in-state procedure involving transfusions that KHPA was willing to fund. The court held:
There is nothing in the language of K.A.R. 30-5-70(c)(2) or any of the Kansas Medicaid regulations to indicate that the regulations either were enacted or are enforced in such a way as to target Jehovah's Witnesses. The regulations are neutral and of general applicability, but the regulations have the incidental effect of burdening Stinemetz' particular religious beliefs. Under the Employment v. Smith test, enforcement of the Kansas Medicaid regulations need not be justified by a compelling governmental interest to avoid violating Stinemetz' rights under the Free Exercise Clause of the First Amendment.
But even the Employment v. Smith test carves out an "individual exemption exception." .... Because the Kansas Medicaid regulations allow for an individual exemption on a case-by-case basis in defining medical necessity, the KHPA cannot refuse to extend that exemption to cover Stinemetz' religious hardship without providing a compelling reason. Here, the KHPA has failed to suggest any state interest, much less a compelling interest....
Stinemetz has even greater protections ... under § 7 of the Kansas Constitution Bill of Rights.... To determine whether government action violates an individual's right to the free exercise of religious beliefs under the Kansas Constitution, a court must determine: (1) whether the individual's religious beliefs are sincerely held; (2) whether the state action burdens the individual's free exercise of religious beliefs; (3) whether the state interest is overriding or compelling; and (4) whether the State uses the least restrictive means of achieving its interest.... [T]he KHPA's denial of Stinemetz' request for prior authorization for the out-of-state liver transplant violated her rights under § 7 of the Kansas Constitution Bill of Rights.
Yesterday's Topeka (KA)
Capital-Journal reported on the decision. (See
prior related posting).
