Eleven Million Reasons Why the ACA Will Stand

03/11/2015 06:41 pm ET | Updated May 11, 2015

The Affordable Care Act (ACA) is working. Nationally, more than 11 million people signed up for coverage in the most recent open-enrollment period. This landmark law, despite what the critics say, has improved the lives of millions of Americans.

When I first came to Congress in 2009, we were knee deep in debating health care reform legislation. Things looked bleak -- nearly 50 million Americans were uninsured, health care costs were rising at unsustainable rates and our quality of care did not measure up to other developed countries. Something had to be done.

My first committee assignment led me to the Education and Labor Committee, which played a critical role in crafting the ACA. As we debated legislation, one thing was clear, we intended to make healthcare an affordable option for all Americans. Nobody should go ill -- or worse, die -- because they could not afford to see a doctor or go to a hospital. Nor should they have to choose between paying their household bills and paying for their medicine. We recognized that if everyone had insurance and access to care -- costs would go down.

And since the ACA was fully implemented, we already see the effects. The number of uninsured Americans went down by 25 percent because coverage became more affordable. Federal tax credits were available to 85 percent of those who enrolled in health insurance plans through the newly established marketplaces. These subsidies brought down the cost of insurance by 76 percent on average.

But, all of this could change with the Supreme Court's decision in King v. Burwell, a case challenging one of the key pillars of the ACA -- affordability. The challengers rest their case on the reading of four words, namely whether the premium tax credits available on exchanges "established by the state" should be limited to individuals who purchase health insurance through exchanges established by states. More than 8 million Americans who get insurance through the federal exchange may lose coverage because they reside in states that did not create their own.

It has been clear from the very beginning, and the hearings where Congress debated the bill, the ACA was always intended to be a national law. It doesn't matter if the exchange was established by your state or by the federal government. What matters is that you are covered.

Thanks to the subsidies under the ACA, low and middle income Americans, regardless of their zip code, are able to afford coverage. And that is why the decision in King v. Burwell is so important. If the Court decides with the challengers' interpretation of the law, millions of people will once again be told that they are unworthy of health insurance because of their income and where they live.

What this would create is two tiered United States of America, one where states like California who set up their own exchanges would have high rates of insured citizens receiving healthcare at a lower cost. And another America in the 34 states who chose not to set up an exchange, where only the wealthiest have insurance. But by kicking millions off their health insurance plans, it would actually be raising costs for all, increasing the burden on even the wealthiest.

After so long, and after so many lives have been saved, we cannot return to the days when 50 million Americans lived without health insurance. The ACA was structured to provide quality, affordable health care for all Americans. And that is exactly why it is such a success. Let's not take a step backward from all the progress we have made.