Across the United States there is a growing demand for national, state, and local governments to recognize and implement health care as a human right. While the Patient Protection and Affordable Care Act offers the promise of expanded and affordable health insurance coverage, it falls short from a human rights perspective. Drawing on human rights principles derived from international law, several state and local initiatives serve as inspiring alternatives. They incorporate universally recognized human rights principles--universality, equality, transparency, participation, and accountability--into health care reforms.