How the Supreme Court’s ‘Obamacare’ Ruling May Lock in Racial Inequity

-the Supreme Court handed President Obama a massive political victory, but not as large as many think. By weakening the federal government’s ability to expand Medicaid through the states, the court threw health care reform for black and brown America into disarray, and flung half of the law’s potential beneficiaries into legal limbo.

As a result, the Patient Protection and Affordable Care Act’s longterm effectiveness is in doubt, and the racial and economic inequalities at the very heart of the health care system stand to be reinforced.

Medicaid—funded jointly by the federal government and the states—is the nation’s health care plan for the working poor, those in poverty and their children. Enlargement of Medicaid is the single most important provision of the Affordable Care Act for people of color. It’s the way that almost all non-whites covered by the law would receive insurance.

If implemented as written, the law expected to cover 32 million Americans, accounting for 80 percent of those currently uninsured. Half of the 32 million are to be brought into the system through Medicaid, and three out of four of those individuals are people of color.

As passed by Congress, the Affordable Care Act broadened Medicaid by compelling states to participate under the threat of a severe penalty. Specifically, it would withdraw all Medicaid funds from a state that did not admit more of the working poor into the program. Yesterday’s ruling declared that method unconstitutional.

For black and brown America, affordable, quality healthcare is key to closing a wider economic gulf.

Inequity is the Problem

The health care market’s inequity—millions in it and millions out of it—necessitates a massive fix. Without correction, the entire system will collapse from the weight of its cost.

America spends more of its national wealth on health care than any other country, but covers a smaller percentage of its population. The way our health care network pays for treatment is the root problem.

Clinicians are compensated for the number of sophisticated therapies doled out, not for whether they are effective. Patients are in care longer, recovery time is extended, and the overall tab is rising. Trying to keep pace, health insurance premiums are going up at twice the rate of everything else.

But America’s working poor can’t keep up. Almost one million people each year have to drop insurance, because they can no longer afford it. Neither can society as a whole.

Medicaid is a mitigating force in this lopsided system. Blacks and Latinos are enrolled in Medicaid at twice the rate of whites. Half of those in the program are children. As the Kaiser Family Foundation has bluntly concluded, “Medicaid enables Black and Hispanic Americans to access health care.”  more from colorlines