07/05/2012 02:32 pm ET | Updated Sep 04, 2012

A Supreme Ruling

Even at age 57, Chief Justice John Roberts, the second-youngest member of the Supreme Court, wisely decided to uphold the Affordable Care Act and the health care interests of millions of seniors in America last Thursday.

When President Obama was elected, 88 percent of Americans -- including my 87 year-old grandmother -- agreed that we needed to do something to fix our ailing health care system. Just four years later, the imperative for change is even greater. Today in the United States, someone turns 65 every eight seconds. This year alone, an estimated 4 million Americans will become senior citizens, the beginning of an unprecedented "age wave" that will add far greater strains to our already struggling health care system.

That's why, for millions of seniors, the Affordable Care Act was a very welcome solution. The law lowers the cost of my grandmother's prescription drugs, reduces rates for private Medicare supplements and expands access to free preventative services. In fact, 26 million seniors received at least one preventative service at no cost in 2011 and more than 5 million benefited from the closing of the prescription drug "donut hole." Between March of 2010 and April of this year, seniors saved over $3.5 billion thanks to the Affordable Care Act. And since women like my grandmother on average live longer than men and African Americans and Latinos are more likely to lack private insurance and publicly-funded insurance, strengthening these programs creates supports where they are needed most.

Still, there's more to be done. To keep up with our aging population, we must create 1.6 million new care jobs in America to support aging independently with dignity. These should be good paying jobs that include training, benefits, workplace protections and a path to citizenship for the many immigrant women who fill these vital roles. Currently, the workers who take care of our parents and grandparents, who help them count their pills and get dressed and live out their lives comfortably at home, make on average less than $10 per hour. We should be taking better care of the workers who take care of our loved ones. Creating good home care jobs with good pay and good benefits is essential to not only the well-being of our families but the future of our economy, too.

Now that the Supreme Court has ruled, hopefully opponents of reform will stop playing their broken record about repeal. The case is now literally closed. My grandmother doesn't have time to re-litigate the past. Now we have an opportunity to move forward with the next generation of solutions to our health care challenges, not keep arguing about the progress we've made.

Unfortunately, the Supreme Court's ruling did put in jeopardy key expansions to Medicaid that, in addition to making insurance coverage accessible to millions of low-income Americans, would have expanded Medicaid access for uninsured, younger seniors my mother's age -- between the ages of 50 and 64. Because the Court limited the federal government's ability to penalize states that do not participate in the expansion of Medicaid, the future of these benefits is now uncertain. The ruling even affects the 16 million older Americans and individuals with disabilities who currently rely on Medicaid for their health care but may not be able to do so if rogue states refuse to support extended benefits. We know from history that vulnerable communities -- including seniors, poor people, people of color and lesbian, gay, bisexual and transgender individuals -- are often on the front lines of such cuts.

The Affordable Care Act was a great step forward in addressing America's health care needs. We still have more steps to take. Over 9 in 10 Americans believe that everyone should be supported to age at home. If we're going to support our aging loved ones with the care they need and the dignity they deserve, we need qualified workers who are also treated with the dignity they deserve.

If Chief Justice Roberts is lucky, we can fix our elder care system before he turns 65.

Ai-jen Poo is co-director of Caring Across Generations (CAG), a national coalition of 200 advocacy organizations working together for quality care and support and a dignified quality of life for all Americans. She is also executive director of the National Domestic Workers Alliance. Named one of Time Magazines Most Influential People in the World, Ai-jen is national leader for workers rights in unorganized industries, and women's rights.