The Ruling Is in: Health Care Reform Stands

Photo courtesy of Voice of America.

In a major victory for people with HIV, 50 million uninsured Americans and The Constitution, the Supreme Court ruled today that the Affordable Care Act will stand as law of the land. The ruling will help link hundreds of thousands of Americans with HIV to the care they need and put the country on track to an AIDS free generation. Currently, 25% of people with HIV are insured, but even among those with some insurance, quality care often proves hard to come by, with only 50% in regular care and only 25% on effective HIV medication. The law's enactment will also make denying coverage to those with pre-existing conditions illegal, and should reduce health insurance premiums and complications for all.

"Today's decision was a victory for people all over the country whose lives will be more secure because of this law and the Supreme Court's decision to uphold it," said President Obama shortly after the decision. "They've reaffirmed a fundamental principal, that here in America, the wealthiest nation on earth, no illness or accident should lead to any family's financial ruin."

However, the ruling by a 5-4 majority, with Chief Justice Roberts as the surprise swing vote, does not uphold the federal government's right to withhold all Medicaid funding from states that refuse to comply with the Act's expansion of who qualifies for Medicaid coverage, leaving questions about how implementation of the law will shake down state by state. "What Congress is not free to do is to penalize states that choose not to participate in that new program by taking away their existing Medicaid funding," reads the opinion authored by Roberts.

It does uphold the mandate that requires every individual to get health insurance or face a penalty, which was considered the most Constitutionally controversial part of the law. However, Roberts stated that the right does not fall under the federal government's right to regulate interstate commerce, as the administration had argued, but by considering the penalty a tax and therefore soundly within the government's bounds. This could set a precedent that limits using the commerce clause as a basis for other national legislation regarding social justice. Regardless, it allows the slow march towards universal health coverage, taken for granted in countries around the world and declared a basic human right by the U.N., to continue.

A predictable storm of sour grapes rained down from Republicans on Capital Hill and Twitter, with Michelle Bachman tweeting that America was now "going into a death spiral." The think tank Third Way fittingly retorted, "The fight over this law is over, and it is time for the GOP to throw in the towel. Congress has debated, their Court has rebuffed them, and now we as a country can move forward to tackle new issues affecting our economy and middle class."