Does treating everyone the same always mean treating them fairly? This is the central question raised in Alsyrawan v. Pennsylvania Department of Human Services (2026). This case involves a Muslim family requesting a religious accommodation from the state of Pennsylvania under the Medicaid-funded caregiving program. Although one may argue this state policy applies equally to all, it raises questions about whether a seemingly neutral law can place an unequal burden on religious exercise for certain families and their beliefs. I find it difficult to justify Pennsylvania's refusal to accommodate the Alsyrawan family's religious obligations when it has granted exceptions in other circumstances.
Mohamad Alsyrawan is a non-verbal autistic adult with Down syndrome and requires extensive assistance, care, and supervision in his day-to-day life. His primary caregivers are his mother and sister, and all three are practicing muslims who emigrated from Syria to the United States in 2001. Under Pennsylvania’s Consolidated Waiver program, Alsyrawan was initially approved for 133 hours of caregiving services per week. Shortly after, the 40/60 state rule was implemented, limiting the hours his family could be paid for providing care to 40 hours per week for one family caregiver or 60 hours total across multiple family members.
The Alsyrawan family requested an 
exception under their Islamic beliefs, which require certain intimate personal care and interactions to be provided only by family members. Without this exception, Mohamad’s mother and sister would have to provide all the care without additional compensation, as certain outside caregiving arrangements could conflict with their religious obligations. Pennsylvania denied their appeal request regardless of their circumstances and argued that alternative caregiving arrangements were possible.
After several years of appeals, the Pennsylvania Supreme Court ruled in favor of Alsyrawan, deciding that to make a religious freedom claim, someone only needs to show that a government rule interferes with their religious practices, not that it causes a substantial burden. This does not automatically mean the government is violating the Constitution, but it does mean the individual’s claim deserves further consideration. The court sent the case back to the lower courts for further proceedings to determine whether this refusal violated the family’s freedom.
The most important question in this case is whether Pennsylvania’s 40/60 state rule places a substantial and detrimental burden on the Alsyrawan family's religious freedom. Technically, the state is not prohibiting the family from practicing Islam or providing care. Instead, the rule is limiting how much the government will pay relatives for providing care to their family. However, I do not believe a burden must involve 
any prohibition to still deserve constitutional protection. Even when the government technically allows someone to continue their religious practices, if it creates serious financial consequences, it can put crucial pressure on them to act against their religious beliefs.
This case reminded me of Sherbert v. Verner, where the Supreme Court held that denying unemployment benefits to a woman who refused Saturday work to observe the Sabbath violated her Free Exercise rights. Similarly, the Alsyrawan family faced the challenge of choosing between their religious beliefs and receiving government assistance. While Sherbert focused on whether the government could justify a substantial burden on religious exercise, Alsyrawan clarified that individuals only need to show a burden exists to establish the initial burden required for a Free Exercise claim. This distinction demonstrates that people should not have to prove their religious practices are severely restricted before courts actually consider whether the government has treated them unfairly by interfering with their beliefs.
On the other hand, a case like Employment Division v. Smith complicates this argument, as the Supreme Court held that a neutral, generally applicable law does not ordinarily violate the Free Exercise Clause just because it burdens religious practices. Alsyrawan follows this framework, emphasizing that individuals don’t actually have to prove a substantial burden before courts consider it a violation or not. This distinction matters because even seemingly neutral laws can still unfairly interfere with religion, especially when the government allows certain exceptions while denying other similar ones for religious purposes.
Facially, the 40/60 rule seems neutral as it applies the same numerical limits to all regardless of religion, race, gender, etc. However, the policy allows temporary exceptions only to certain circumstances, such as emergencies or the unexpected absence of a caregiver. More importantly, Pennsylvania has previously granted an individualized 
exception outside those circumstances. This makes me wonder: if the government has authority to accommodate certain people, why should religious obligations receive different consideration?
Under Church of the Lukumi Babalu v. Hialeah, the Supreme Court struck down laws targeting the Santeria religion’s animal sacrifice practice. Although it does not seem Pennsylvania is targeting Islam in the way Hialeah targeted Santeria, Lukumi demonstrates the importance of examining how laws operate, not just relying strictly on their wording. I believe Pennsylvania’s exceptions deserve similar examination. While I understand an emergency and a permanent religious obligation are not identical, the state should have to explain why those differences justify refusing religious accommodation.
It is fair to say Pennsylvania has a legitimate interest in managing public funds, maintaining consistent standards, and ensuring reliable care. However, if strict scrutiny applies, the government must then demonstrate a compelling state interest and be able to show that less restrictive alternatives would not adequately achieve its goals. Could Pennsylvania allow carefully documented religious exceptions while periodically reviewing whether families still qualify? I believe this approach could protect the integrity of the caregiving program without unnecessarily burdening religious exercise.
The sincerity of the Alsyrawan family's beliefs matters, and his mother even testified that she and her daughter would continue providing care regardless of whether they did receive the additional compensation. This suggests their religious obligations are genuine, not just a financial preference or a facade to get more money. Even if the courts do examine sincerity, they should not have the autonomy to decide if a particular practice is actually central to Islam or if other Muslims would interpret their religion differently.
Some may argue that allowing this exception creates a slippery slope, encouraging other families to request additional compensation for whatever reason they see fit. This concern deserves consideration, especially when public resources are in fact limited. However, the possibility of future requests should not automatically justify dismissing constitutional protections. Each request should be evaluated in depth based on its circumstances and the government’s justification.
Ultimately, I believe Pennsylvania should grant a carefully limited accommodation, that is, if the family is able to establish its claim and the state is unable to prove that the refusal is necessary to protect a compelling state interest. This does not mean all religious requests should override government policy, but rather that the state must justify its decisions when its own rules inconsistently allow flexibility. Alsyrawan shows that religious freedom should be judged not only by whether a law appears neutral, but also by how the government applies it. A law that treats all equally is not necessarily one that protects all religious freedom equally.
Sources:
https://law.justia.com/cases/pennsylvania/supreme-court/2026/87-map-2024.html?utm_source=chatgpt.com
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