HCAO response to Supreme Court ruling on ACA mandate

Health Care for All Oregon welcomes the survival of important patient protections and rights under the Supreme Court decision on the Affordable Care Act. These protections include the ban on refusal of coverage for pre-existing conditions, the required full coverage of limited basic primary care, and the extension of coverage of adult children under parental insurance through age 25. These elements move the human right to health care in the U.S. forward.


A strength of the ACA was the effort to guarantee access to health care through Medicaid to the lowest-income workers not already eligible.  That guarantee has now been turned into a struggle to be fought state-by-state. This deplorable blow to low income working families weakens  the extension of the principle of social insurance in health care. It reinforces the need for a system that truly secures the human right to health care for everyone.  

The ACA remains inadequate. The Act categorically excludes millions of undocumented persons and will leave over 25 million persons in the U.S. uninsured. The system of private insurance continues to collapse, imposing on families a rising requirement to pay more for less. The rapid spread of high deductibles and high co-pays will lead to continued self-rationing, expensive delayed care, and continued widespread medical bankruptcy.

The ACA creates no effective mechanism for shifting care priorities to health promotion, primary care and prevention, nor for reforming perverse incentives in provider compensation. It perpetuates massive avoidable administrative waste and fragmentation of the system.

Meanwhile, Medicaid, Medicare and the ACA itself remain under political attack.

Ultimately, the ACA fails to resolve the health care access and costs crises. It does not secure the human right to health care, which can only be guaranteed through a massive social movement. While welcoming the survival of patient rights and expanded access under the Affordable Care Act, Health Care for All Oregon continues to advocate for a truly universal publicly funded system that guarantees the fundamental right to health care to everyone living in the United States. Everybody In, Nobody Out!