Yesterday, the Supreme Court handed down a decision that is bound to go down in the history books as monumental. While the Affordable Care Act (ACA) has been the subject of endless debate, commentary, political jockeying and legal analysis, yesterday we learned a simple lesson: real people can win.
A lot was at stake. The ACA is the most substantial investment in our nation's health system in decades. Had the Supreme Court struck it down, our country would have been sent backward on an unsustainable path.
In upholding President Obama's crowning achievement, the Supreme Court validated what many health advocates believe to be a landmark civil rights law, one that brings the work of equity and justice to the health arena. The law lays a foundation -- lacking for far too long -- for the nation to make the push toward health equity and to ensure that everyone has the opportunity to good health and quality care.
The law makes key investments and reforms in the nation's public health infrastructure that will not only improve the nation's health but will particularly help racial and ethnic minorities and other diverse communities who have long languished in a health system that fails to meet their needs.
The law has already made an important dent by extending coverage to young people, providing coverage for more than 6 million young adults -- 1.3 million of whom are racial and ethnic minorities, including 97,000 Asian Americans and Pacific Islanders -- who now have access to health insurance they otherwise would not be able to afford.
And an estimated 32 million Americans are expected to gain coverage under the ACA in the coming years, making a significant reduction in the nearly 50 million people in the United States who are uninsured. For the first time, moderate income families will have access to subsidies, tax credits and increased competition that will help them shop for and enroll in more affordable health insurance. This will not only provide peace of mind for many individuals and families who no longer have to worry about what happens if they fall ill, but will -- for the first time for many -- provide them with affordable health insurance and access to care. The ACA's coverage expansions will help to close the insurance gap among racial and ethnic minorities, who are already disproportionately uninsured compared to whites. Having access to insurance coverage is strongly linked with having access to more dependable and preventive care -- essential tools to combating health disparities.
In addition, the Supreme Court's decision yesterday allows states to expand Medicaid eligibility to persons up to 133 percent of the federal poverty level. This provision alone has the potential to extend coverage to an estimated 17 million low-income individuals, including nearly 1 in 10 Asian Americans and more than 1 in 8 Native Hawaiians and Pacific Islanders. While the Court removed some of the teeth this provision carried by limiting the government's ability to completely withdraw Medicaid funding if a state refuses to comply with the law, states can still expand their programs and will receive significant funding from the government to help them cover these vulnerable populations.
The ACA also extends federal nondiscrimination protections to the health system for the first time in U.S. history. This means that federal programs, and any entity or program that receives federal money, cannot discriminate on the basis of race, color, national origin, gender or disability. The ACA's civil rights protections are a crucial step toward ensuring that health plans and programs provide meaningful access to undeserved communities, including those who are limited-English proficient and need language assistance.
Yesterday, real people won. Yet even after this victory, there remains a lot to do. Now comes the hard part of implementing many of the law's most significant provisions -- such as ensuring that all communities understand the law's many benefits and working with states to expand Medicaid eligibility for their most vulnerable. The ACA is a huge step toward a more equitable health system. Thanks to the Supreme Court's decision yesterday, it will undoubtedly improve the lives of many communities of color and our entire nation.
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