Is Health Care a Constitutional Right?

No, there is no constitutional right to health care in the United States. Despite measures such as the Affordable Care Act, there is no fundamental right to medical care in this country. While health care is not a right, laws have created certain healthcare protections. These rights include legally mandated access to medical care and emergency medical services.

The U.S. doesn’t have universal, government-paid health care. But federal law offers specific protections for U.S. patients. Some laws mandate certain levels of coverage by insurance companies.

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. A few states allow terminally ill patients to end their lives through assisted suicide.

This article focuses on federal laws concerning health care and patient rights. If you’re unsure which rights apply to your situation, a healthcare attorney near you can explain your options and help you navigate federal and state protections.

Healthcare Options Under Federal Law

Americans have several sources to get health care. Many people get health care through employer-sponsored plans or the federal health insurance marketplace. Older Americans can turn to Medicare, and low-income individuals can turn to Medicaid.

Several federal laws help more people gain access to health care. A few of these laws include the following:

• EMTALA: Emergency Medical Treatment and Active Labor Act of 1996
• ACA: The Affordable Care Act of 2010
• HIPAA: Health Insurance Portability and Accountability Act of 1996

The Right to Emergency Care

Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986. It 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
• Transfer the patient to a different medical facility

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 the facility stabilize a patient without the precondition of payment or proof of insurance coverage.

The Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) ushered in a host of comprehensive federal health care regulations. The law aimed for universal coverage by requiring residents to have health insurance. It included a penalty for noncompliance. Congress overturned that provision in 2017. The U.S. Department of Health and Human Services (HHS) administers the ACA.

The ACA provides the following protections for patients, among others:

• Health insurers cannot deny insurance coverage based on preexisting conditions.
• Most health care plans must cover certain preventive services at no cost to the patient, including screenings and vaccinations.
• Individuals under 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.

Privacy Rights and Protection

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives patients rights over their health information. HIPAA’s Privacy Rule confers these rights on patients. Under the HIPAA Privacy Rule, patients have the right to:

• See and examine their health records
• Correct patient information contained in their medical records

HIPAA’s Privacy Rule applies to “covered entities,” including:

• Healthcare providers
• Health care clearinghouses, which are organizations that provide information services to health plans
• Health plans
• Business associates that provide services to or on behalf of a covered entity.

HIPAA’s Privacy Rule protects patients against a covered entity’s unauthorized disclosure of their protected health information. For example, a healthcare professional cannot leave a patient’s electronic file unattended. Doing so could expose the patient’s protected health information to unauthorized disclosure.

Patients can file a complaint with the Office for Civil Rights (OCR) for HIPAA violations.

In general, you can’t sue for a HIPAA violation. But that doesn’t mean you don’t have options. A local healthcare attorney can assess what happened, determine whether a covered entity violated your rights, and explain your options.

Informed Consent

Informed consent is an integral part of your medical treatment decision-making process. Informed consent is part of a patient’s right to refuse treatment. Patients need an opportunity to understand the proposed medical treatment and ask questions before deciding on a treatment plan.

Health care providers must inform patients or their designated caregivers of:

• The treatment or procedure the patient needs
• Potential benefits of the treatment or procedure
• Potential risks of the treatment or procedure
• Alternatives to the treatment or procedure

Healthcare providers who do not get informed consent face severe consequences. This includes potential malpractice lawsuits.

Patient Bill of Rights

Although organizations like the American Hospital Association (AHA) have published “Patient Bill of Rights” documents, there is no national Patient Bill of Rights. Instead, many healthcare facilities publish their own Patient Bill of Rights based on the AHA’s document. A few common patient rights include the right to:

• Respectful care consistent with your beliefs
• Complete information from your provider about your medical condition or treatment plan
• Refuse treatment
• Copies of your medical records
• Continuity of care
• Make advance directives

Patient advocates at many healthcare facilities handle potential violations of patient rights. Their contact information is often printed on the Patient Bill of Rights.

Additional Health Coverage Protections

Federal laws afford more protections for patients. These include protections against certain forms of discrimination for coverage and services. These include, but aren’t limited to:

• Women’s Health and Cancer Rights Act: Requires insurance companies that cover mastectomies also to cover breast reconstructive surgery.
• Mental Health Parity and Addiction Equity Act: Insurance companies must offer mental health and addiction services on 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 based on race, color, or national origin.
• Genetic Information Nondiscrimination Act of 2008 (GINA): Prohibits employers from discriminating against employees based on their genetic information, including access to employer-sponsored health care plans.

Get Legal Help With a Healthcare Issue

Although the U.S. does not guarantee a right to health care, state and federal laws offer some protections. If you have questions about your patient rights, a health care attorney can help you. They can explain your rights and responsibilities and advocate for you. Speak to an experienced healthcare lawyer near you.