United Nations: Repealing Obamacare May Violate International Law

Just when we thought attempts to repeal the Affordable Care Act were dead, the GOP tried it again. The latest attempt, which was previously shelved, would grant states “sweeping power” to opt out of key ACA provisions, Politico reported last week. It would leave millions of Americans without access to healthcare coverage. And that could violate international law, says the United Nations.

The Office of the U.N. High Commissioner on Human Rights in Geneva sent a letter to the U.S. State Department voicing concerns about repealing the Affordable Care Act, more commonly known as Obamacare.

The letter, obtained by the Washington Post last week, expresses “serious concern” that nearly 30 million people would lose healthcare coverage, which may violate “the right to social security of the people in the United States.” The Office recommends that “all necessary interim measures be taken to prevent the alleged violations,” and if they prove “to be correct ... adequate measures” must be taken to “prevent their occurrence.”

The letter cites Article 25 of the Universal Declaration of Human Rights (UDHR) which “establishes everyone’s rights to a standard of adequate living,” and that includes health and well-being. The UDHR has become “a source and expression of international customary law, and all states, including the United States of America, are obliged to protect and guarantee the rights enshrined therein,” the Office asserted. 

Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) establishes everyone’s rights “to enjoyment of the highest attainable standard of physical and mental health," the Office stated in its letter. And state parties have the “core obligation to ensure the right of access to health facilities, goods and services on a non-discriminatory basis.” ICESCR also mandates that health facilities, goods and services must be “affordable for all.” The U.S. signed the covenant in 1977, but never ratified it. However, the U.S. is still obligated to avoid acts that would defeat the covenant’s purpose.

There are two other ways a repeal of the ACA could violate international law, the Office asserted. Under Article Five of the International Convention on the Elimination of All Forms of Racial Discrimination, states have to guarantee everyone’s right to “a number of economic, social and cultural rights” without discrimination, including the rights to public health and medical care. The U.S. ratified the convention in 1994. No. 14 of the Committee on Economic, Social and Cultural Rights establishes the obligation of states to guarantee the right to health without discrimination.

The American people overwhelmingly do not support repeal of the ACA. Only 37 percent of those polled say it should be repealed and replaced, according to an ABC poll, while 61 percent say it should remain and be fixed. A large majority (79 percent) say President Donald Trump should find a way to make the ACA work better and not make it fail.

Most Americans don’t want the ACA repealed and replaced because it has been a success. From 2010 to 2015, 19 million people gained healthcare coverage as a result of the law. There is an old adage that if it ain’t broke, don’t fix it. President Trump and congressional members would do well to listen to the American people and not fix what works with the ACA, but work to improve it.

While the GOP plans an ACA repeal, a bill introduced into California’s state senate in February would provide single-payer universal healthcare to all Californians. State Sen. Ricardo Lara said he introduced the bill because he “felt it was important that we create a different narrative here in California." San Francisco already provides a single-payer system for uninsured city residents called Healthy San Francisco.  

If California is successful in passing the bill, it would put it in a unique role of being the only state to provide what residents of Canada and European countries have long enjoyed.

Image credit: Flickr/Franco Dal Molin