U.S. Supreme Court Upholds Landmark Health Reform Law

By Tucker, Charlotte | The Nation's Health, August 2012 | Go to article overview

U.S. Supreme Court Upholds Landmark Health Reform Law


Tucker, Charlotte, The Nation's Health


AFTER MORE THAN two years of questions about whether it would hold up in court, the Patient Protection and Affordable Care Act stands. The June Supreme Court decision means that more than 31 million previously uninsured people will be able to obtain health coverage by 2019.

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Looking beyond the politics and the polemics, the Supreme Court's decision means that public health will have within its arsenal a vast range of tools to fight the health problems that plague the United States.

In the June 28 ruling, the court found the Affordable Care Act and the requirement to obtain insurance or pay a small penalty constitutional. But it also said that states cannot be financially penalized for not expanding their Medicaid programs to cover more people.

APHA Executive Director Georges Benjamin, MD, FACP, FACEP (E), said the decision "marks tremendous progress toward reshaping our health system into one that saves the lives of at least 44,000 people who die annually simply because they do not have health insurance that could keep them healthy."

"The Supreme Court did the right thing by upholding the Affordable Care Act," Benjamin said. "APHA is overjoyed by today's ruling."

Unfortunately, just because the Supreme Court ruled on the Affordable Care Act does not mean the fight is over. Since its passage in March 2010, Congress has held votes to repeal the law more than two dozen times, and some opponents have pledged to continue the attacks. In fact, just two weeks after the court's decision, some House lawmakers made another attempt to repeal the law.

In the meantime, health reform moves ahead. Though big parts of the Affordable Care Act, such as state-based health insurance exchanges, do not go into effect until 2014, the law phased in other reforms that have already made an impact. Starting in the 2011 fiscal year, community health centers saw increased funding that allowed them to nearly double the number of patients they were seeing.

Beginning in 2010, young people were permitted to remain on their parents' insurance until they turned 26. That change meant that 3.1 million young people had health insurance who were not able to obtain it through school or employers before. The law also helped children with pre-existing conditions get coverage, and 14 million children with private insurance received preventive health services with no co-pay, according to the American Academy of Pediatrics.

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The law also gives 54 million families better access to preventive health care services, such as vaccines and preventive care and screenings for women.

Among the tools created by the Affordable Care Act is the Prevention and Public Health Fund, which provides funds to combat preventable chronic diseases such as heart disease, cancer, stroke and diabetes, which account for 75 percent of the nation's health spending. A recent report from Trust for America's Health found that investing $1 in proven community-based programs could yield a five-year return of $5.60.

The fund is nothing less than an "investment in the future health of America," according to Trust for America's Health, and despite recent cuts, the fund will still provide billions of dollars over the next decade for injury and disease prevention.

Decision charts course for road ahead

The survival of the law almost completely intact removes uncertainty among many in the public health community. It allows states to move ahead with exchanges that will allow those not covered by employer-sponsored care to buy health insurance. It lays out a way forward for the next few years that many said will put America on a path toward achieving a wholesale change in the way the country views health. …

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