Isabella Carter
Healthcare is not explicitly protected by the US Constitution, but there have been arguments that the denial of a minimal level of healthcare to poor persons transgresses the equal protection guarantees under the Constitution. The Fourteenth Amendment's Equal Protection clause and Title VI of the Civil Rights Act have the capacity to reduce health disparities, but neither has achieved its full potential because of how the judicial branch has interpreted and allowed these laws to be enforced. The Supreme Court has upheld a requirement in the Patient Protection and Affordable Care Act (Affordable Care Act/ACA) that most individuals carry health insurance or pay a penalty for noncompliance as a valid exercise of Congress' authority to levy taxes. Congresswoman Betty McCollum has also introduced America's Right to Health Care Amendment, which enshrines a right to healthcare in the Constitution and instructs Congress to enforce that right through legislation.
| Characteristics | Values |
|---|---|
| Health care as a constitutional right | The United States Constitution does not set forth an explicit right to health care |
| Health care as a legal right | The Supreme Court has never interpreted the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it |
| Health care reform debate | Coverage, accessibility, cost, accountability, and quality of health care |
| Health equity | Elimination of differentials in access to health services according to race, ethnicity, sex, gender identity, comorbidity, or ability |
| Fourteenth Amendment to the Constitution | Equal Protection clause |
| Title VI of the Civil Rights Act | N/A |
| Patient Protection and Affordable Care Act (Affordable Care Act/ACA) | Requirement that most individuals carry health insurance or pay a penalty for noncompliance |
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What You'll Learn
The Supreme Court's recognition of Congress's power to tax
The United States Constitution does not set forth an explicit right to healthcare. However, arguments have been made that the denial of a minimal level of healthcare to poor persons transgresses the equal protection guarantees under the Constitution. The Fourteenth Amendment's Equal Protection Clause and Title VI of the Civil Rights Act have the capacity to reduce health disparities, but in practice, neither has achieved its full potential.
The Supreme Court has recognised that Congress's power to tax is extremely broad. In United States v. Doremus, the Court stated that if legislation enacted has some reasonable relation to the exercise of the taxing authority conferred by the Constitution, it cannot be invalidated because of the supposed motives that induced it. In National Federation of Independent Business v. Sebelius, the Supreme Court upheld a requirement in the Patient Protection and Affordable Care Act that most individuals carry health insurance or pay a penalty for non-compliance as a valid exercise of Congress's authority to levy taxes.
The health care reform debate raises many complex issues, including coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. Congresswoman Betty McCollum has introduced America's Right to Health Care Amendment, which enshrines a right to health care in the Constitution and instructs Congress to enforce that right through legislation.
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The Fourteenth Amendment's Equal Protection Clause
While the United States Constitution does not set forth an explicit right to healthcare, arguments have been made that the denial of a minimal level of healthcare to poor persons transgresses the equal protection guarantees under the Constitution. The Fourteenth Amendment to the Constitution's Equal Protection Clause is one such example. While the Equal Protection Clause of the Fourteenth Amendment applies only to the states, similar equal protection principles are applicable to the federal government through the Due Process Clause of the Fifth Amendment.
Despite the potential of the Fourteenth Amendment's Equal Protection Clause to reduce health disparities, it has not been fully realised due to how the judicial branch has interpreted and enforced the law. One example of a challenge to federal action regarding healthcare is the National Federation of Independent Business v. Sebelius (NFIB) case, in which the Supreme Court upheld a requirement in the Patient Protection and Affordable Care Act (Affordable Care Act/ACA) that most individuals carry health insurance or pay a penalty for non-compliance.
To address the lack of an explicit right to healthcare in the Constitution, Congresswoman Betty McCollum introduced America's Right to Health Care Amendment. This proposal seeks to enshrine a right to healthcare in the Constitution and instructs Congress to enforce that right through legislation. According to Congresswoman McCollum, "a large majority of Americans agree that the federal government has a responsibility to make sure all Americans have health coverage".
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The Fifth Amendment's Due Process Clause
While the US Constitution does not set forth an explicit right to healthcare, arguments have been made that the denial of a minimal level of healthcare to poor persons by the federal government transgresses the equal protection guarantees under the Constitution. The Fourteenth Amendment's Equal Protection Clause applies only to the states, but similar equal protection principles are applicable to the federal government through the Due Process Clause of the Fifth Amendment.
The Due Process Clause of the Fifth Amendment also provides a basis for challenging federal actions that place an undue burden on the exercise of an individual's fundamental rights. In the context of healthcare, this could include challenging policies or laws that restrict access to essential healthcare services or impose unreasonable barriers to obtaining healthcare. For example, if a federal policy were to require individuals to obtain prior authorization for certain medical treatments, thereby delaying or denying access to necessary healthcare, it could be challenged as an undue burden on the right to healthcare.
The Supreme Court has recognised that Congress's power to tax is extremely broad. In *United States v. Doremus*, the Court stated that if legislation enacted has some reasonable relation to the exercise of the taxing authority conferred by the Constitution, it cannot be invalidated because of the supposed motives that induced it. This means that Congress has the authority to enact legislation that impacts healthcare, such as the requirement in the Patient Protection and Affordable Care Act (Affordable Care Act/ACA) that most individuals carry health insurance or pay a penalty for non-compliance.
While the Fifth Amendment's Due Process Clause provides some protection for healthcare rights, it is important to note that the Supreme Court has never interpreted the Constitution as guaranteeing a right to healthcare services from the government for those who cannot afford it. However, proposals such as America's Right to Health Care Amendment seek to enshrine a right to healthcare in the Constitution and instruct Congress to enforce that right through legislation.
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The Patient Protection and Affordable Care Act (Affordable Care Act/ACA)
While the United States Constitution does not set forth an explicit right to healthcare, arguments have been made that the denial of a minimal level of healthcare to poor persons by the federal government transgresses the equal protection guarantees under the Constitution. The Fourteenth Amendment's Equal Protection Clause and Title VI of the Civil Rights Act are two examples of tools that can be used to reduce health disparities and achieve health equity in the United States.
The Supreme Court's decision in NFIB v. Sebelius also upheld most of the provisions of the Affordable Care Act. This decision recognised that Congress's power to tax is extremely broad and that the legislation enacted must have some reasonable relation to the exercise of the taxing authority conferred by the Constitution.
Despite the lack of an explicit right to healthcare in the Constitution, the Affordable Care Act represents an effort by the federal government to ensure access to healthcare for all Americans. This is further supported by proposals such as the America's Right to Health Care Amendment, which seeks to enshrine a right to healthcare in the Constitution and instruct Congress to enforce that right through legislation.
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The America's Right to Health Care Amendment
Although the United States Constitution does not set forth an explicit right to health care, the America's Right to Health Care Amendment is a proposal to enshrine a right to health care in the Constitution and instruct Congress to enforce that right through legislation. The proposal is a simple, two-sentence amendment that reads: "Section 1. Health care, including care to prevent and treat illness, is the right of all citizens of the United States and necessary to ensure the strength of the Nation".
The amendment is based on the argument that the denial by the federal government of a minimal level of health care to poor persons transgresses the equal protection guarantees under the Constitution. While the equal protection clause of the Fourteenth Amendment applies only to the states, similar equal protection principles are applicable to the federal government through the Due Process Clause of the Fifth Amendment.
The health care reform debate raises many complex issues, including coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. The United States Supreme Court has never interpreted the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it. However, in National Federation of Independent Business v. Sebelius (NFIB), the Supreme Court upheld a requirement in the Patient Protection and Affordable Care Act (Affordable Care Act/ACA) that most individuals carry health insurance or pay a penalty for noncompliance as a valid exercise of Congress' authority to levy taxes.
To achieve health equity, governments can use a variety of tools, including civil rights legislation and constitutional jurisprudence. In the United States, two such examples are the Fourteenth Amendment to the Constitution's Equal Protection Clause and Title VI of the Civil Rights Act. While both have the capacity to reduce health disparities, in practice, neither has achieved its full potential because of how the judicial branch has interpreted and allowed these two laws to be enforced.
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Frequently asked questions
No, the US Constitution does not set forth an explicit right to healthcare.
The Patient Protection and Affordable Care Act (Affordable Care Act/ACA) upheld by the Supreme Court in 2014 requires that most individuals carry health insurance or pay a penalty for noncompliance.
Yes, Congresswoman Betty McCollum introduced America's Right to Health Care Amendment in 2017. This proposal would enshrine a right to healthcare in the Constitution and instruct Congress to enforce that right through legislation.
