The throngs of lawyers, protesters and advocates have all gone home. They'll now hold their collective breath until the Supreme Court delivers its verdict, most likely in June. What's decided will affect our political and legal system forever and reverberate throughout our health care system and every aspect of American life that it touches.
We know a lot about what the United States will look like if the justices uphold the Affordable Care Act.
• Virtually every single person in this country will have health care coverage. Up until the Affordable Care Act, the United States remained the only industrialized that didn't provide affordable health insurance options for all (our health care expenses were higher and health outcomes worse than most of those countries too).
• An emphasis on preventive services will save lives and preserve precious health care resources that are now spent on treating illnesses that are far more expensive when diagnosed later.
• Better and more secure health care for more than 50 million men, women and children currently on Medicaid in the United States. With more Americans assured of health coverage, they will lead more productive lives and have more money to invest in things like education, the key to escaping poverty.
But what if the justices strike down the law in its entirety? The right wing may cheer, but the results could be catastrophic for the health of our nation and for our economic and moral place in the world.
Here's what America might look like:
• We will still have 50.7 million Americans without health insurance. Some of them simply will go without care until they face an emergency. And when those emergencies are encountered, those visits will cost them (really, us) much more than regular health coverage. The average family pays more than $1,000 extra per year in health care premiums to cover the costs incurred by the uninsured.
• Americans with cancer, HIV or other pre-existing illnesses could be denied insurance coverage forever, driving them into poverty and onto public health services and into economic dependency.
• We will continue wasting more than $700 billion every year on unnecessary procedures.
• Women will continue to be charged 50 percent more than men for the same exact coverage (coverage that does not include pregnancy and maternal care), putting them at an economic as well as health disadvantage and disproportionately hurting single moms.
Without the Affordable Care Act, more people will be sicker, more people will pay more for their own care, and more people will pay more for other people's care.
The Supreme Court has more than a legal case to consider this spring. It has the future of our nation to decide.