The U.S. Supreme Court decision upholding the constitutionality of the Patient Protection and Affordable Care Act (ACA) represents a significant advancement in the effort to repair the deeply-broken U.S. healthcare system and promote equitable opportunities for good health for all. As long as its provisions are fully funded by Congress, the law will improve access to health insurance for more than 32 million Americans, prevent insurance companies from cherry-picking enrollees and denying claims because of pre-existing conditions, and incentivize more health-care providers to work in medically underserved communities.
These are among the benefits that the law is already providing, in addition to what is expected as provisions of the ACA come into force over the next two years.
In addition to ruling that the law’s mandate requiring insurance coverage is constitutional, the Court’s decision ensures that other key provisions of the legislation remain intact, many of which hold great promise to address the needs of those who face the greatest barriers to good health—particularly people of color, who are the fastest-growing segment of the U.S. population.
Many people of color face poorer health than the general population in the form of higher rates of infant mortality, chronic disease and disability and premature death. Not only do these health inequities carry a tremendous human toll, but they also impose an enormous economic burden on the nation at large. A study released by the Joint Center for Political and Economic Studies found that the direct medical costs associated with health inequities—in other words, additional costs of health care incurred because of the higher burden of disease and illness experienced by minorities—was nearly $300 billion in the four years between 2003 and 2006.
Adding the indirect costs associated with health inequities—such as lost wages and productivity and lost tax revenue—the total costs of health inequities to our society was $1.24 billion in the same time span.
How might the ACA change these dismal statistics?