Concerns over the future of the Affordable Care Act don't end at the U.S. border, according to a report from The Washington Post. Officials with the United Nations warned the Trump administration that repealing Obamacare could violate international laws if it is deemed "retrogressive ... in relation to the right to health."
Dainius Pūras — a UN official whose lengthy title is "Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health" — outlined concerns over how repealing the ACA without a replacement could harm nearly 20 million U.S. citizens. He also explained how, in addition to failing to meet standards to which the United States holds other countries, a hasty repeal could violate several articles of global laws that protect the rights to "a standard of living adequate for the health and well-being, including food, medical care and necessary social services" and ones geared toward protecting marginalized groups. Via Pūras' confidential letter sent to the U.S. State Department in early February and obtained by Washington Post columnist Dana Milbank:
I would like to bring to the attention of your Government information I have received concerning the possibility to repeal core elements of the Affordable Care Act (ACA) with negative impacts on the right of everyone to the enjoyment of the highest attainable standards of physical and mental health in the United States in particular those with moderate or low income and in situations of poverty or social exclusion.
The laws cited by Pūras include Article 25 of the Universal Declaration of Human Rights (UDHR), Article 5(e) of the International Covenant on Economic, Social and Cultural Rights (ICESCR), and Article 12 of the International Convention on the Elimination of All Forms of Racial Discrimination. While the UN can't necessarily do much about potential violations, Pūras wrote that the UN committee on Economic, Social, and Cultural Rights "has stressed the progressive realization of the right to health, which means that States have a specific and continuing obligation to move as expeditiously and effectively as possible towards its realization."
Pūras also wrote that the committee considers measures that move backward in that regard "are not permissible" and concluded that the U.S. government would be required to prove that they considered "all alternatives" and that they are "duly justified" based on their "maximum available resources" to repeal Obamacare.
Additionally, The Washington Post reported that the Office of the UN High Commissioner on Human Rights (OHCHR) requested the letter be given to majority and minority leaders in Congress. However, the offices of Speaker of the House Paul Ryan and Senate Majority Leader Mitch McConnell told the Post they were unaware of the letter and the offices of House Minority Leader Nancy Pelosi, Senate Minority Leader Chuck Schumer said they didn't receive it. A spokesperson for the State Department also told the Post that the publication's request for comment was the first time they'd heard of the letter. (Bustle has reached out to the aforementioned offices for comment.)
Pūras' representatives told The Washington Post that he wouldn't be able to comment on the memo until the inquiry becomes public in June during the Human Rights Council's next session. As Republicans attempt to revive their "repeal and replace plan," the coming months will undoubtedly be eventful for the future of American healthcare.