Is Health Care a Right?
The 1948 United Nations Universal Declaration of Human Rights proclaims that "Everyone has the right to a standard of living adequate for the health and well-being of oneself and one's family, including ... medical care." Similarly, the 2005 World Health Assembly resolution 58.33 states that everyone should have access to health care without having to worry about their financial situation.
The United States signed onto both of these non-binding documents that at least suggest a fundamental right to medical services. But is health care a right?
Americans have passionate, deeply philosophical opinions about whether health care should be a constitutionally guaranteed right. However, this article focuses on how laws have created certain rights with respect to health care, including legally mandated access to medical care and emergency services.
Is Health Care a Right Guaranteed Under Federal Law?
The U.S. Constitution does not guarantee the right to health care services, unlike the constitutions of more than half of the world's nations. Furthermore, the United States had the second-lowest rate of health care coverage among industrialized nations in 2015.
Health care in the United States must be obtained either through one's employer, from the private marketplace, or (if you're elderly or indigent) via Medicare or Medicaid. But while there's no guaranteed right to get the medical care you need, federal law sets certain standards and protections for access to care and ensures the right to obtain emergency medical services regardless of one's ability to pay.
Emergency Treatment and Labor Act: The Right to Emergency Care
Congress passed the Emergency Treatment and Labor Act (EMTALA) in 1986, which grants U.S. residents the right to limited emergency medical and childbirth services. The law states that if anyone enters a hospital and hospital staff determines that they have an emergency medical condition (including active labor), then they must provide either:
- Further medical examination and any treatment required to stabilize the patient; or
- Transfer of the patient to another medical facility (in accordance with certain rules and restrictions).
This law applies to all hospitals that receive Medicare funding, which includes the vast majority of U.S. hospitals. This law doesn't allow for free access to care; it merely requires that needed care be provided in order to stabilize a patient, without the precondition of payment or proof of insurance coverage.
Health Care Access and the Law
Despite the lack of universal, government-paid health care -- typically provided in countries where health care is a guaranteed right -- federal law does afford certain protections for U.S. patients. Many of these laws mandate certain levels of coverage by insurance companies, which are motivated to keep costs low while boosting revenue.
State laws also protect certain patient rights that aren't reflected in federal law. For instance, many states protect the rights of qualifying patients to use cannabis to treat their ailments, while a few states allow terminally ill patients to end their own lives through assisted suicide. Some states extend protections for LGBTQ individuals as well.
The following is a summary of federal laws regarding access to health care services.
The Affordable Care Act
The Patient Protection and Affordable Care Act (ACA) ushered in a host of comprehensive federal health care regulations. While the law aimed for universal coverage by requiring residents to purchase or otherwise obtain health insurance, with a penalty for non-compliance, that provision was overturned by Congress in late 2017.
The ACA provides the following protections for patients (this isn't a complete list):
- Health insurers may not deny coverage on the basis of preexisting conditions.
- Most health care plans are required to cover certain preventive services at no cost to the patient, including screenings and vaccinations.
- Individuals under the age of 26 may obtain coverage under a parent's health care plan.
- Lifetime and yearly dollar limits on certain core services are prohibited.
- Health insurers may no longer cancel your coverage for getting sick or injured.
Medicare, Medicaid, and CHIP
Although Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) are all federally funded health care programs, they each serve very different needs, as noted below:
- If you're a low-income person of any age, you may qualify for free coverage under Medicaid, which is administered through the states.
- If you're 65 or older and have paid into Medicare through payroll taxes for at least 10 years, you may qualify for subsidized (not free) Medicare insurance coverage.
- If your family income is too high to qualify for Medicaid, but you're unable to purchase health insurance, your children may qualify for coverage under CHIP, which is administered by the U.S. Department of Health and Human Services.
Additional Health Care Coverage Protections
Federal laws afford additional protections for patients, including protections against certain forms of discrimination with respect to coverage and services. These include, but aren't limited to, the following:
- Women's Health and Cancer Rights Act - Requires insurance companies that cover mastectomies to also cover breast reconstructive surgery.
- Mental Health Parity and Addiction Equity Act - Requires insurance companies to offer mental health and addiction services on a par with medical and surgical coverage.
- Consolidated Omnibus Budget Reconciliation Act (COBRA) - Requires insurers of employer-sponsored plans to extend coverage to employees who experience a change in employment.
- Title VI of the Civil Rights Act of 1964 - Prohibits denial of assistance or services on the basis of race, color, or national origin.
- Genetic Information Nondiscrimination Act of 2008 (GINA) - Prohibits employers from discriminating against employees on the basis of their genetic information, including access to employer-sponsored health care plans.
Protect Your Health Care Rights: Meet With an Attorney
While there's no guaranteed right to health care in the United States, state and federal laws do provide certain protections for patients. If you have additional questions about your health care rights and responsibilities, or believe your rights have been violated, your best option is to get in touch with an experienced health care attorney near you.