I don’t think I’ve ever felt so anxious about a pending Supreme Court decision. So I cheered when SCOTUSblog broke the news that the court had supported all of the Affordable Care Act, except for the ruling that the federal government could not deny states payment for current Medicaid services if states decided not to expand these services. I had heard that Chief Justice Roberts could rule in favor of supporting the law because he didn’t want his court to go down in history as one of the most political we have seen. His vote was key to the ruling.
Within an hour of the court’s ruling, House Speaker John Boehner said that House Republicans would vote to repeal the law. Until the elections, the Senate is highly unlikely to follow suit and the president would certainly veto any repeal. This makes the fall presidential and Congressional elections all the more important.
The ACA is not perfect. There is lots that needs to be done to refine it–even to ensure that everyone in the country has access to health care (the ACA reduces the numbers of the uninsured but doesn’t cover everyone). But it does improve access, reforms the insurance industry, and begins to transform our health care system into one that emphasizes health promotion, prevention and better management of chronic illnesses.