Supreme Court Ruling And Interconnectedness

In a landmark decision, the United States Supreme Court today upheld the constitutionality of the Obama Administration’s Affordable Care Act of 2010.

In the official opinion, Chief Justice John Roberts wrote:
Today we resolve constitutional challenges to two provi­sions of the Patient Protection and Affordable Care Act 2010: the individual mandate, which requires individuals to purchase a health insurance policy providing a mini­mum level of coverage; and the Medicaid expansion, which gives funds to the States on the condition that they pro­vide specified health care to all citizens whose income falls below a certain threshold . . . The Affordable Care Act’s requirement that certain in­dividuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Be­cause the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.

President Obama praised the long-awaited decision saying that the American people “understand that we don’t need to re-fight this battle over healthcare.” He then added, “It’s the right thing to do, that we got 3 million young people who are on their parents’ health insurance. It’s the right thing to do to give seniors discounts on prescription drugs. It’s the right thing to do give 30 million Americans health insurance.”

Today’s news certainly impacts state and federal laws, hospital operations, individual insurance decisions and more. However, whether you are for or against the ruling, it’s worth noting that Texas’ ongoing air pollution struggles particularly impact the underprivileged and currently uninsured, who may put off lung-related medical or hospital visits due to financial limitations. And with a number of Texas facilities poised to expand, such as Exxon’s Baytown facility, Dow Chemical Co., and Chevron Phillips Chemical Co., we should be reminded that the issues of health insurance, air pollution and disease are interconnected and that we can do a better job of protecting human health.  Protecting human health from air toxics is especially important in Texas as one of every three citizens in Texas lives without health insurance, causing the Texas Medical Association to dub Texas the “uninsured capital of the United States.” More than 6.3 million of our citizens – including 1.2 million children – lack health insurance coverage, which translates into lives with “far-worse health status than their insured counterparts” and the creation of “significant problems in the financing and delivery of health care to all Texans.”


Ultimately, we all pay the price. Poor air quality simply makes things worse for those uninsured and battling lung illnesses such as chronic bronchitis, chronic obstructive pulmonary disease or asthma. For asthma sufferers alone, inpatient hospitalization charges totaled more than $446 million in 2007 according to the Asthma Coalition of Texas, which also states that most of these hospitalizations were “preventable with proper asthma management.”

Of those admissions, how many without health insurance could have avoided a hospital trip given proper asthma management beforehand? How many other citizens with pollution-related illnesses forego early medical treatment due to lack of insurance? Finally, how much do we all pay for those hidden costs like missed workdays and lost productivity?

If you want to learn more about the implications of the Affordable Care Act to public health, the American Public Health Association is hosting a webinar on July 5 to discuss what the ruling means for the country.

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