Health Care Civil Rights Under Medicare for All

Abstract

The passage of Medicare for All would be the greatest advancement in health care policy that this country has seen. The legislation would go a long way towards curing the inequalities that plague our health care system along racial, sex, age, health status, and disability lines. While creating a human right to health care, Medicare For All may inadvertently have the effect of dampening civil rights, an outcome its creators and supporters surely would not intend for it. Federal money is typically requisite for civil rights enforcement; Title VI, Title IX, and the Age Discrimination Act of 1975 all only apply to recipients of federal financial assistance.

Under Medicare for All, the federal government would be the payer, not recipient, of federal funds, leaving it outside civil rights enforcement. Additionally, because of historic quirks in how we interpret civil rights law, Medicare for All money might not bring health care providers, like doctors, under civil rights enforcement. All of this is to say that Medicare for All would create a vacuum in civil rights applicability—one that lawmakers would have to fill if we want nondiscrimination by doctors and health benefits administrators. Medicare for All becomes an opportunity for lawmakers to reimagine the possibilities of civil rights in health care. Lawmakers have been none too deliberate about this process in the past, with civil rights being a byproduct rather than a goal of health reform. With careful planning, Medicare for All, and similar reforms that aim towards single-payer systems, can generate a meaningful and intentional civil rights movement in health care that leaves our country with more robust civil rights protections for patients in the future.

Keywords: health reform, Medicare for All, civil rights, health policy, health discrimination, health justice, health disparities