Health Care Amendment

Comprehensive healthcare shall include all services, goods, and supports necessary for the preservation and restoration of health and function, including but not limited to: medical, surgical, mental-health, substance-use-disorder, dental, vision, hearing, reproductive, and sexual-health services; and the provision of all medically necessary pharmaceuticals, durable medical equipment, and assistive devices.

Such care shall encompass preventive, primary, acute, specialty, long-term, rehabilitative, and palliative services, provided using medically appropriate, evidence-based standards as defined by law.

Care shall be guided by the principles of equity, medical necessity, and public accountability.

Congress shall ensure the system provides and annually defines and updates all services and technologies consistent with the prevailing, evidence-based professional standards of medical practice in the United States.

The definition and periodic update of professional standards shall be based on recommendations of nationally recognized medical and scientific bodies independent of political influence.

Congress shall not define the standard of care below the level widely recognized and generally accepted by the medical and public health communities for the treatment of specific conditions.

The United States shall establish, fund, and maintain a universal, publicly administered, non-profit healthcare system securing the right recognized in Section 1.

This system shall operate under the exclusive authority of Congress as a core federal responsibility.

The obligation of the United States to protect the health of the people shall extend to reasonable measures safeguarding the underlying social and environmental determinants of health directly affecting public health and healthcare delivery.

This obligation includes maintaining national systems for disease prevention, emergency preparedness, and epidemic control as integral components of healthcare delivery.

Healthcare under this system shall be free to all persons at the point of service, with no direct charge, premium, deductible, copayment, or other out-of-pocket cost to any person for services provided under this system.

Congress shall ensure stable and sufficient public financing through fair and transparent means, including progressive taxation or other lawful assessments, and shall maintain a permanent Healthcare Trust Fund, dedicated solely to the full and continuous financing of this system and whose assets shall not be subject to congressional appropriation or reallocation for any non-healthcare purpose, except by a supermajority vote of two-thirds of both Houses.

In administering this right, Congress shall ensure fiscal responsibility, efficiency, and annual public review and publication of system performance, fiscal condition, and equity outcomes to guarantee the system’s long-term viability and responsiveness to the health needs of the people.

States may administer healthcare facilities or programs consistent with federal standards but shall not alter or restrict rights guaranteed herein.

No person, including all citizens of the United States and all persons authorized to reside permanently or temporarily within the United States, including refugees and asylum seekers lawfully present, shall be excluded from or provided unequal access to the federally mandated healthcare system.

No person shall be deprived of medically necessary, emergency, or essential services due to inability to pay, preexisting condition, disability, age, sex, gender identity, sexual orientation, race, religion, national origin, or any other status.

The provision of care shall not be contingent upon employment, income, insurance status, or place of residence.

Every person shall have the right to choose their physician, hospital, and other available healthcare providers within the system.

The provision of care shall respect the clinical judgment and professional autonomy of healthcare providers, consistent with the standards established by law.

Every person has the right to medical privacy, including the confidentiality of medical records, genetic information, and health data in any electronic or physical form.

Data and biological samples necessary for public health, healthcare administration, or approved scientific or medical research may be used without individual authorization when they are fully anonymized or de-identified so that no personal identity can reasonably be reconstructed.

Any use of identifiable medical, biometric, or genetic information shall require the prior, explicit, freely given, and revocable informed consent of the individual to whom such information pertains.

Medical information, biometric data, and DNA obtained through the healthcare system may be used for non-care or non-research purposes only pursuant to a judicial warrant issued upon probable cause.

Every person shall have the right to obtain, review, and correct their own medical records in accordance with standards established by law.

The federally administered healthcare system shall be operated efficiently, transparently, and equitably.

The United States shall not impose or permit excessive administrative burdens, filing requirements, or other obstacles that obstruct timely access to medically necessary care.

The United States shall ensure, through independent oversight, the annual public reporting of system performance to:

1. Detect and eliminate disparities in quality of care, health outcomes, and access among different populations;

2. Compare cost efficiency, health outcomes, and service delivery across regions and facilities;

3. Ensure transparency, fiscal integrity, and continuous improvement in quality of care;

4. Report on the Administrative Review Process (ARP), including the total volume of complaints, average time to resolution, percentage of denials upheld and overturned, and demographic data regarding appeals and outcomes;

5. Evaluate, on an annual basis, all laws, regulations, and policies enacted pursuant to this Article, and those with a primary purpose of affecting healthcare or health outcomes, including their measurable impact on quality, access, equity, and cost; and

6. Authorize and support the use of anonymized or de-identified health data for scientific, medical, and policy research consistent with the privacy protections established in Section 5, to advance evidence-based improvement of public health and care delivery.

Congress shall establish an independent Office of Healthcare Accountability, reporting directly to both Houses of Congress, to oversee data integrity, audit compliance, and certify the annual reports required by this Article.

The Office of Healthcare Accountability shall be nonpartisan and independent, and its officers shall be removable only for cause as defined by law.

All required reports shall be published and made publicly accessible no later than 90 days after the close of each fiscal year, free of charge, and in accessible digital form.

Failure to produce or release such reports constitutes non-compliance with this Article and shall be subject to enforcement under Section 8.

The Administrative Review Process itself shall be subject to independent audit and inclusion in the annual public report.

Congress shall establish by law national standards for the education, training, licensing, and professional accountability of healthcare providers, ensuring competence, ethical practice, and equitable distribution of the medical workforce.

Congress shall provide for a coordinated system of medical education and residencies at no cost to qualified students, sufficient to meet projected national healthcare needs.

A federal credentialing and disciplinary registry shall prevent professionals found incompetent or unethical in one jurisdiction from resuming practice in another and shall include mandatory national reporting of all final disciplinary actions and verified malpractice judgments.

Healthcare professionals shall be subject to continuous evaluation under uniform national performance and quality-of-care standards to ensure ongoing professional excellence and patient safety.

Each licensed caregiver shall undergo an annual performance and quality scoring process administered by the federal healthcare authority for internal administrative use only.

Such evaluations shall be used exclusively for quality improvement, resource allocation, and oversight purposes and shall not be disclosed for commercial, advertising, or non-governmental use.

Congress shall ensure that sufficient medical personnel, facilities, and supply reserves are maintained to respond to public-health emergencies and sustain uninterrupted care.

A. Administrative Review Process (ARP) as Exclusive Individual Remedy

Except as provided in paragraph B, all individual claims alleging denial or violation of rights under this Article shall be resolved exclusively through the Administrative Review Process established by Congress. No court shall have jurisdiction over individual claims arising under this Article.

B. Life-Threatening Exception and Legal Representation

When a denial of medically necessary services is life-threatening, an individual may seek immediate declaratory or injunctive relief in the courts of the United States without first utilizing the ARP.

A denial is life-threatening when the failure to provide immediate treatment creates an imminent and substantial risk of death to the individual.

Judicial relief shall be limited to orders necessary to secure the medically necessary care.

Individuals bringing such actions shall be entitled to publicly funded legal representation through a national Medical Public Defender System, or, if they elect private counsel, to reimbursement of reasonable attorney’s fees and related legal costs only if they prevail.

No damages shall be awarded in any such action.

C. Medical Injury Compensation

Congress shall establish a national, non-profit medical liability and indemnity system providing fair and timely compensation for verified medical injury.

Punitive and non-economic damages are prohibited.

Compensation shall be limited to verified, direct, compensatory damages necessary to restore the injured party’s health, wages, and function as nearly as possible.

Verified findings of malpractice or negligence within the indemnity system shall automatically inform the professional-accountability and disciplinary registry established under Section 7.

Congress shall ensure that the indemnity system remains adequately funded, transparent, and equitable.

D. State Enforcement of Systemic Compliance

The Attorneys General of the several States shall have standing to bring actions in federal court against the United States or its agencies to remedy systemic or sustained failures of the national healthcare system that result in widespread denial of rights guaranteed by this Article.

Such systemic failures include, but are not limited to, those defined in paragraph E.

Relief in such actions shall be limited to declaratory and injunctive measures necessary to restore compliance with this Article.

E. Definition of Systemic Violation

For purposes of this Article, a systemic violation includes any action, omission, or sustained failure by the United States that results in:

1. The systemic or categorical denial of medically necessary services guaranteed by this Article;

2. Systemic or statistically significant deterioration of public-health outcomes, including infant and maternal mortality, preventable disease burden, or average life expectancy, relative to achievable standards among developed nations;

3. Deliberate congressional or administrative actions, omissions, or regulatory barriers that materially obstruct, delay, or complicate the timely approval or delivery of medically necessary care; or

4. Substantial impairment of funding, administration, or operational capacity of the healthcare system established by this Article.

F. Supremacy and Permanence

The rights and responsibilities established by this Article shall apply equally to all persons under the jurisdiction of the United States.

Congress shall have the power to enforce this Article by appropriate legislation.

The rights established herein shall be judicially enforceable as specified in this Section.

No State law shall abridge, delay, or undermine the rights secured by this Article.

No suspension or deferral of rights guaranteed by this Article shall be lawful, even in time of war or national emergency.

Congress shall enact all legislation necessary to implement this Article within two years of its ratification, and full system operation shall commence not later than five years thereafter.
During the transition period, no person shall lose access to healthcare services or insurance coverage that they lawfully possess at the time of ratification.

Should Congress fail to enact the necessary legislation within the two-year period, the Supreme Court of the United States, upon petition, shall have the authority to establish provisional rules and standards necessary to initiate the implementation of this Article until such time as Congress fulfills its legislative duty.