Vanderbilt Law Review

First Page



The need to make health care available to all Americans does not justify the impairment of governmental contracts with Hill-Burton grantees. When substantial rights are greatly impaired by retroactive legislation, the need for a strong governmental justification becomes more acute. The impairment caused by the post-1947 Hill-Burton regulations, particularly the 1979 regulations, is neither reasonable nor necessary in light of the nature and extent to which they impair substantial private rights. The recent Hill-Burton regulations attempt to make health care more available to Americans,but the Government seeks to do this without additional financial expenditure on its part. Although the goal is noble, the means are improper.

To allow the Government to unilaterally, unnecessarily, and drastically alter the contractual obligations owed by assisted Hill-Burton facilities to the Government is to deny Hill-Burton grantees the constitutional protection of fifth amendment due process. The post-1947 Hill-Burton regulations, particularly the 1979 regulations,pertaining to the uncompensated service and community service assurances, do not merely clarify or serve to accomplish the intent of the original Hill-Burton Act. These regulations retroactively impair valid contractual obligations. In light of recent Supreme Court decisions, these regulations are unconstitutional.