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Friday, April 27, 2012

What's Missing from the Court Coverage and What to Do about It

Marc Steinberg

Deputy Director of Health Policy

There's been no shortage of analysis about the Supreme Court arguments on the constitutionality of the Affordable Care Act. A lot of it has focused on the politics and tea-leaf reading: How will the Justices vote? What could the different outcomes mean for the November election? Will the law be upheld or will the conservatives on the court disregard legal precedent, strike down the law, and start a partisan legal revolution?

These are all important questions. But the truth is nobody outside the walls of the Supreme Court can predict with certainty how the Court will rule. The most important number for health care in this country between now and June, when the Court is expected to rule, isn't the billions of dollars politicians are arguing about. It isn't even the 270 electoral votes needed to win in November (though that will matter soon). It's "five"-the number of votes needed for a majority in the Supreme Court. The Court seems deeply divided: The four more liberal Justices (Breyer, Ginsburg, Kagan, and Sotomayor) are likely votes in support of the law. Three conservatives (Alito, Scalia, and presumably Thomas-as usual, he did not ask questions) are opposed. That leaves two (Kennedy and Chief Justice Roberts) in the middle. They asked tough questions of both sides, and how those two will rule on the various questions before the Court is anyone's guess.

But there is a vital perspective that's been missing from much of the coverage about the Affordable Care Act and the Supreme Court, particularly when we talk about what's at stake. It's the perspective of everyday people whose health, and whose lives, are now in the hands of the Supreme Court.

During the Congressional debate during 2009 and 2010, supporters of what became the Affordable Care Act spoke in hypothetical terms about what the public stood to gain from the law if it were enacted. Now, we need to talk in very concrete terms about how the highest court in the land could strip us of critical protections that we have or are about to gain. Every American with a stake in these protections should be speaking out. If you, a friend, or loved one has a health condition-for example, cancer, diabetes, high blood pressure, arthritis, or a back injury-that makes it hard or impossible to buy health insurance, your well-being is at risk. If you thought that, finally, you would not have to live in fear of bankruptcy because of high medical bills, think again-a bad decision from the Court would put us right back where we were. If you have been rolling the dice every time you walk out the door because you can't afford health insurance and are just hoping you don't get sick, and you thought that at last security was within your grasp, well, five justices of the Supreme Court could strip that security away from you.

There has been some terrific coverage in recent weeks about people who would suffer if the Court were to strike down the law. Stories about people in car accidents; about children born with cerebral palsy; about people with ulcerative colitis. There need to be more. In the coming weeks, Families USA will be launching new efforts to get these stories out and to make the voices of everyday people heard. But don't wait. Tell your story now. Explain how you, or someone you know, would be harmed if the Supreme Court struck down the health care law. Write a letter or submit a guest column to your local paper. Post your story on your local blogs. Share your story with the Families USA storybank. Now is the time to speak up and let people know that we do not live in a country where the highest court in the land would undermine the health security of millions-or at least, we sure hope we don't.