Title: Health Care: Constitutional Rights and Legislative Powers - EveryCRSReport.com
Headings: Health Care: Constitutional Rights and Legislative Powers
Health Care: Constitutional Rights and Legislative Powers
Health Care: Constitutional Rights and Legislative Powers
Contents
Summary
Health Care Rights Under the U.S. Constitution
Explicit Rights in the U.S. Constitution
The Right to Health Care at the Government's Expense
Substantive Due Process: Impact on Fundamental Rights
Equal Protection: Wealth as a "Suspect Class"
Exception: Under Government Control
Health Care Legislation Under the U.S. Constitution
Specific Sources of Constitutional Authority
The Power to Tax and Spend for the General Welfare
The Power To Regulate Interstate Commerce
Federal Health Care Programs
The Affordable Care Act
Supreme Court Decision in National Federation of Independent Business v. Sebelius
State Attempts to "Nullify" or "Opt Out" of Affordable Care Act Requirements
State statutes and constitutional amendments
Interstate compacts
State Constitutions and the Provision of Health Care Services
Footnotes

Content: The United States Supreme Court’s decision in NFIB v. Sebelius, which upheld most of the Patient Protection and Affordable Care Act (Affordable Care Act/ACA), is also discussed. The United States Constitution does not set forth an explicit right to health care, and 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. The Supreme Court has, however, held that the government has an obligation to provide medical care in certain limited circumstances, such as for prisoners. Congress has enacted numerous statutes, such as Medicare, Medicaid, and the Children’s Health Insurance Program, that establish and define specific statutory rights of individuals to receive health care services from the government. As a major component of many health care entitlement statutes, Congress has provided funding to pay for the health services provided under law. Most of these statutes have been enacted pursuant to Congress’s authority to “make all Laws which shall be necessary and proper” to carry out its mandate “to ... provide for the ... general Welfare.” Congress has also used other constitutional powers, such as its power to regulate interstate commerce and its power to levy taxes, to enact legislation relating to health insurance and health care. In 2010, Congress enacted the Affordable Care Act, a comprehensive health care reform law which includes a requirement, effective in 2014, that most individuals purchase health insurance, and which significantly expands the Medicaid program. A number of lawsuits were filed challenging various provisions of this legislation, and, on June 28, 2012, the Supreme Court upheld the majority of ACA’s provisions. Significantly, the Court upheld the requirement that individuals purchase health insurance as a valid exercise of Congress’ taxing power, but the Court limited Congress’ power to spend for the general welfare by holding that Congress cannot threaten the states with the loss of all federal Medicaid funds if the states decline to expand Medicaid coverage as mandated by ACA.