If the COVID-19 pandemic has taught Americans anything, it must be the need to ensure that everyone has access to decent medical care. After all, it’s not enough to ensure that the wealthy can be treated or receive preventive care, it is in everyone’s best interests that hospitals are not overwhelmed when a virus breaks out and the Herd immunity is achieved through widespread vaccination to truly defeat such a threat. Yet time and again we have witnessed this fundamental inequity for 16 months: those who can afford full medical care, those who do not suffer often. This is nothing new. It’s a long-standing problem and one of the main reasons before the pandemic, blacks in the United States had a life expectancy four years shorter than whites.

Thursday’s US Supreme Court ruling upholding the Affordable Care Act, which since its passage 11 years ago has sought to help close this gap between the have and have not in healthcare, is encouraging . Not just because he keeps Obamacare in place, but because he did so with an exclamation mark – a 7-2 decision that even included Judge Clarence Thomas. When such a conservative court dismisses Republican states’ efforts to kill the ACA (even because of a technicality like the elimination of the individual mandate four years ago), it doesn’t take a legal expert to recognize that Barack Obama’s iconic national achievement is not going away. This is the third defense of the law by the Supreme Court; surely even the most ardent opponents of the GOP will give it rest.

As of this month, an estimated 31 million Americans have health insurance through the ACA markets or the Medicaid extension of the law, according to data from the US Department of Health and Human Services. Equally significantly, the nation has experienced a decline in the rate of uninsured people for much of the past decade. This was true not only in Maryland where ACA was enacted, but in the Red States which reluctantly accepted ACA benefits, such as broader Medicaid eligibility or the requirement that insurers cannot refuse coverage due to a pre-existing medical condition. Yet too many Americans still do not have health insurance. And during the Trump administration, there was a slight increase in uninsured rates for non-seniors, from 10% in 2016 to almost 11% in 2019.

This is why a win in California against Texas is great, but it would be better to build on the success of the Affordable Care Act. There are still several million Americans whose medical needs are not being met under the existing program. To his credit, President Joe Biden has already taken a few steps in this direction, adding a special enrollment period in February as funds from the American Rescue Plan help make ACA coverage more affordable this year. Yet further steps must be taken. And it should start with GOP leaders dropping their misplaced antagonism to the law which was, after all, a compromise that preserved private insurance instead of moving towards a single-payer or “Medicare for All” system. as the Liberals wanted. Republican voters benefited from the ACA. Their elected leaders just don’t want to admit it.

This year alone, the Maryland General Assembly approved legislation creating a pilot program targeting young adults between the ages of 18 and 40 earning up to $ 51,520 with subsidized coverage purchased in the individual health insurance market. Lawmakers also passed a bill committing $ 59 million to “health equity resource communities” to specifically address health disparities in low-income neighborhoods for the next five years. . This kind of creative approach, to provide incentives and opportunities for people who might otherwise be insecure, is exactly what is needed. Creative, smart, focused and profitable ACA extension.

Oh, it won’t be easy for some critics to change their tone and stop talking about Obamacare as a government “takeover” of medicine or a Communist plot. But it probably hasn’t been easy either for conservatives who initially opposed social security in the 1930s (though nearly three dozen other countries had already adopted some form of social insurance). Signature changes such as cost of living adjustments (1950) or disability insurance (1954) were adopted many years after the program was initially adopted. Social Security may need a few more tweaks and better funding, but it’s been generations that no one has seriously talked about removing this government safety net.

In his official statement, President Biden called the ACA Supreme Court ruling a “major victory for all Americans.” It certainly is. But it is also not the end of the story to deliver greater equity in health care.