The U.S. Supreme Court's historic decision to uphold the Patient Protection and Affordable Care Act lifts a heavy burden from millions of Americans who need access to healthcare coverage. The promise of coverage—the cornerstone of any equitable approach to healthcare—may now become a reality for them, their families and communities.
But the decision also leaves it up to each state to decide whether to participate in expanded Medicaid coverage, and that prolongs the uncertainty for a yet-to-be-determined number of people who might have qualified for coverage. Given the significant federal financial support that will be available to states that opt in, we hope that the promise of coverage will be fully realized.
Lack of insurance coverage has consequences for individuals, their families and society at large that go far beyond the obvious—lost health and longevity. It precipitates lost workplace productivity; financial stress on individuals, families and communities; and uncertainty for healthcare providers. The Affordable Care Act is an imperfect law and does not offer coverage to every American, but it substantially increases the number of people who can look forward to enjoying better health and security. It also puts in place delivery system reforms that better align provider incentives to improve care coordination and quality and reduce costs.