Already, people are benefiting from popular provisions of the 2010 law, which fully kicks in 18 months from now: Retirees, and all women, now have access to preventive care like mammograms and wellness visits. Nearly seven million young adults remain on their parents' health plans. An additional 5.3 million Medicare recipients reaped $3.7 billion in savings on medicine. With old lifetime limits of private insurance gone, you can no longer run out of coverage.
Meanwhile, the business of medicine is being transformed by mergers like the just-announced linkage of the Abington and Holy Redeemer health systems, the digitizing of patient records, and the expansion of best practices that are more affordable and, therefore, accessible.
Now the court has made it possible to look to 2014, when individuals will be able to shop for coverage on new insurance exchanges — their premiums reduced by subsidies based upon income.
It's hard to imagine that Republicans once disparaged "Obamacare" as little more than a mandate to eat your vegetables. Conservative Justice Antonin Scalia was the one who tossed out the GOP talking point, asking when the case was argued whether Congress could also require everyone to eat broccoli because it's healthy.
With Chief Justice John G. Roberts Jr. joining the liberal wing to cast the deciding vote, the court rightly rejected such trivialization. While the justices brushed back a heavy-handed expansion of state Medicaid programs for the poor — in effect, making that optional — they ruled that Congress was well within its rights to impose a tax penalty on those who don't acquire insurance by 2015.
As Roberts wrote of the penalty, "It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance."
Although as unpopular as broccoli, taxes are legal — even if abhorred by the no-new-taxes ideology that drove GOP attorneys general in 26 states to challenge the ACA.
No doubt, critics will contine to steam over the health-care law. But most citizens actually favor the benefits that the ACA promises, and what's most important about this pivotal ruling is that it keeps the nation on track to help millions of people live healthier lives.
