Health-Care Issues Edging Back Toward States After GOP Victory

MAGGIE TINSMAN, a Republican state senator from Iowa, says one of the biggest issues now facing state lawmakers is health care.

Ms. Tinsman's view is one that is likely to be echoed more and more by legislators from Maine to California.

They have the recent elections partly to thank for that. Republicans, who swept both Houses of Congress, have not made national health-care reform a high priority. Thus, many observers expect the focus to shift more to the states.

Robin Read, executive director of the National Order for Women Legislators (NOWL), says this is one reason health and wellness were chosen as key topics for the group's annual meeting this week in Naples, Fla. Women legislators, she says, need to be prepared for this shift.

To do that, NOWL, a nonpartisan group, invited a range of speakers - from medical doctors to religious leaders - to address health care.

``We've brought together totally divergent points of view, but they have more in common than we thought possible,'' Ms. Read says.

Read referred to two speakers in particular who represent different backgrounds: Robert McAfee, president of the American Medical Association, and Virginia Harris, Chairman of the Christian Science Board of Directors.

Dr. McAfee emphasized to the legislators that what was needed was not health-care reform. ``It's the system we have to fix,'' he said. ``We are going to have to address everyone's health-care concerns together in this country, and that movement I think is so powerful.''

Mrs. Harris said: ``The laws of our land must provide a level playing field on which people can choose, without penalty, what they feel will help them most. Among the choices of health-care systems there needs to be the choice of caring for one's health through the worship of God and spirituality.''

Freedom to practice religion was an important part of the day's discussion, and both lawyers and religious representatives urged the legislators to be more aware of the Religious Freedom Restoration Act (RFRA).

``It's the best-kept secret - the most important legislation protecting religion since the First Amendment,'' says the Rev. Oliver Thomas, a lawyer for the National Council of Churches.

Passed in 1993, RFRA had the support of an unusual coalition of liberals, conservatives, and religious-rights groups. It was supported by both Sens. Edward Kennedy (D) of Massachusetts and Orrin Hatch (R) of Utah, as well as Reps. Newt Gingrich (R) of Georgia and Barney Frank (D) of Massachusetts.

RFRA states that before it can ``substantially burden'' the exercise of religion, the government must show that its action: 1) serves a ``compelling governmental interest'' and 2) is the ``least restrictive means'' of furthering that interest.

In 1990, the United States Supreme Court decided in Employment Division v. Smith (the ``peyote case'') that, despite the free-exercise clause, the government may fire and deny unemployment compensation to native Americans who used the drug as part of a centuries-old religious worship service.

But the Court's reasoning set the tone and determined the outcome of future cases. By a 5-4 vote, the Court ruled that (for the most part) whenever a law is ``generally applicable'' to all citizens and is not aimed specifically at religious practice, the government need not give a compelling reason for restricting religion.

After the peyote decision, lower-court rulings showed that the effects of the case extended beyond native Americans to other religious citizens. For example, a Christian couple claimed the right to refuse to rent an apartment to an unmarried couple. Yet, under the peyote case, the free-exercise clause did not protect this right.

In 60 cases from 1990 to 1993, courts used the new standard to support government action that purportedly interfered with religious rights.

RFRA restores protection to religious freedom. For instance, a landlord who refuses to rent to an unmarried couple on religious grounds can now raise RFRA as a defense to a charge of discrimination in housing. Also, churches can use RFRA to challenge zoning ordinances that attempt to keep churches or synagogues out of certain neighborhoods.

``Be supportive of (RFRA),'' the Rev. Elenora Giddings Ivory, director of the Washington Office of the Presbyterian Church, urged the legislators. ``We're concerned about justice and the rights of persons.''

It's important to ``make sure you can give religious people some options when you do legislation,'' Rev. Thomas said.

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