{ "id": "R40846", "type": "CRS Report", "typeId": "REPORTS", "number": "R40846", "active": true, "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department", "versions": [ { "source": "EveryCRSReport.com", "id": 410009, "date": "2012-07-09", "retrieved": "2016-04-06T21:45:26.347325", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": "The health care reform debate raises many complex issues including those of 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. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. The United States Supreme Court\u2019s decision in NFIB v. Sebelius, which upheld most of the Patient Protection and Affordable Care Act (Affordable Care Act/ACA), is also discussed.\nThe 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. \nCongress has enacted numerous statutes, such as Medicare, Medicaid, and the Children\u2019s 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\u2019s authority to \u201cmake all Laws which shall be necessary and proper\u201d to carry out its mandate \u201cto ... provide for the ... general Welfare.\u201d 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. \nIn 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\u2019s provisions. Significantly, the Court upheld the requirement that individuals purchase health insurance as a valid exercise of Congress\u2019 taxing power, but the Court limited Congress\u2019 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.\nIn addition, several states have passed laws, amended their state constitutions, or entered into interstate compacts to attempt to \u201cnullify\u201d or \u201copt out\u201d of the federal individual health insurance mandate and other federal health care provisions. Direct conflicts between federal laws and state nullification statutes or state constitutional amendments would raise constitutional issues which are likely to be resolved in favor of federal law under the Supremacy Clause of the United States Constitution. \nA number of state constitutions contain provisions relating to health and the provision of health care services. State constitutions may provide constitutional rights that are more expansive than those found under the federal Constitution since federal rights set the minimum standards for the states.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R40846", "sha1": "2218dca42300e1d4f97b5cdeb88a427fe8a84b80", "filename": "files/20120709_R40846_2218dca42300e1d4f97b5cdeb88a427fe8a84b80.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R40846", "sha1": "27d29c09b692d83ed3386e207cb0e31b58775fcc", "filename": "files/20120709_R40846_27d29c09b692d83ed3386e207cb0e31b58775fcc.pdf", "images": null } ], "topics": [] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc86551/", "id": "R40846_2012Mar23", "date": "2012-03-23", "retrieved": "2012-06-15T10:07:48", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": "The health care reform debate raises many complex issues including those of 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. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. Following the passage of the Patient Protection and Affordable Care Act, P.L. 111-148, legal issues have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to \"nullify\" or \"opt out\" of such a requirement. These issues are also discussed.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20120323_R40846_af4754a64287ce5e71b548006bc83e12ad7e5e09.pdf" }, { "format": "HTML", "filename": "files/20120323_R40846_af4754a64287ce5e71b548006bc83e12ad7e5e09.html" } ], "topics": [ { "source": "LIV", "id": "Medical care", "name": "Medical care" }, { "source": "LIV", "id": "Access to health care", "name": "Access to health care" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" }, { "source": "LIV", "id": "Medicaid", "name": "Medicaid" }, { "source": "LIV", "id": "Medicare", "name": "Medicare" }, { "source": "LIV", "id": "Health insurance", "name": "Health insurance" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc808394/", "id": "R40846_2011Nov03", "date": "2011-11-03", "retrieved": "2016-03-19T13:57:26", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": null, "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20111103_R40846_9d1f306dce3064cf28efca8118461bc13550066e.pdf" }, { "format": "HTML", "filename": "files/20111103_R40846_9d1f306dce3064cf28efca8118461bc13550066e.html" } ], "topics": [] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc491545/", "id": "R40846_2010May18", "date": "2010-05-18", "retrieved": "2015-01-27T19:40:46", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": "The health care reform debate raises many complex issues including those of 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. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. Following the recent passage of the Patient Protection and Affordable Care Act, P.L. 111-148, legal issues have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to \"nullify\" or \"opt out\" of such a requirement. These issues are also discussed.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20100518_R40846_5f45d0776e823f2db0f4425baffd0eb5f89e0db2.pdf" }, { "format": "HTML", "filename": "files/20100518_R40846_5f45d0776e823f2db0f4425baffd0eb5f89e0db2.html" } ], "topics": [ { "source": "LIV", "id": "Medical care", "name": "Medical care" }, { "source": "LIV", "id": "Access to health care", "name": "Access to health care" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" }, { "source": "LIV", "id": "Medicaid", "name": "Medicaid" }, { "source": "LIV", "id": "Medicare", "name": "Medicare" }, { "source": "LIV", "id": "Health insurance", "name": "Health insurance" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc503449/", "id": "R40846_2010Apr05", "date": "2010-04-05", "retrieved": "2015-04-30T17:37:21", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": "This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. It also discusses legal issues that have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to \"nullify\" or \"opt out\" of such a requirement.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20100405_R40846_2bda824f386ed07342bb18a1e9b3da978af4bb79.pdf" }, { "format": "HTML", "filename": "files/20100405_R40846_2bda824f386ed07342bb18a1e9b3da978af4bb79.html" } ], "topics": [ { "source": "LIV", "id": "Medical care", "name": "Medical care" }, { "source": "LIV", "id": "Access to health care", "name": "Access to health care" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" }, { "source": "LIV", "id": "Medicaid", "name": "Medicaid" }, { "source": "LIV", "id": "Medicare", "name": "Medicare" }, { "source": "LIV", "id": "Health insurance", "name": "Health insurance" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc689479/", "id": "R40846_2009Oct05", "date": "2009-10-05", "retrieved": "2015-08-03T15:06:47", "title": "Health Care: Constitutional Rights and Legislative Powers", "summary": "This report discusses constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20091005_R40846_33b2f92348efe8a52b247eee2fa9aeb8b75a3b1c.pdf" }, { "format": "HTML", "filename": "files/20091005_R40846_33b2f92348efe8a52b247eee2fa9aeb8b75a3b1c.html" } ], "topics": [ { "source": "LIV", "id": "Medical care", "name": "Medical care" }, { "source": "LIV", "id": "Access to health care", "name": "Access to health care" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" }, { "source": "LIV", "id": "Medicaid", "name": "Medicaid" }, { "source": "LIV", "id": "Medicare", "name": "Medicare" }, { "source": "LIV", "id": "Health insurance", "name": "Health insurance" } ] } ], "topics": [ "Constitutional Questions", "Domestic Social Policy" ] }