With the Supreme Court decision upholding the Affordable Care Act (ACA), it’s a good time to look at what the law does (and doesn’t do).

The best parts of the law:

• By expanding Medicaid and strengthening insurance rules, some people will be covered who couldn’t get health coverage
• Seniors will get some help in paying for prescription drugs.
• Community health programs will get much-needed funding.
• Children can stay on their parent’s health plan up to age 26.

The worst parts of the law:

• It does little to control healthcare costs.
• It’s not universal. The Congressional Budget Office has predicted it will leave 27 million people without coverage, a number that could rise dramatically if many states opt out of Medicaid expansion.
• There are big loopholes in the reforms intended to protect people from insurance companies.
• It is a huge windfall for insurance companies, hospitals, and pharmaceutical corporations.

Overall, the law protects and expands the reach of the private insurance system. Its most progressive element, the Medicaid expansion, was undermined by the court decision which allowing individual states to opt out. This could substantially reduce the promise of expanded coverage.

The next steps for comprehensive reform:

NNU Co-President Karen Higgins, RN, “nurses experience the crisis our patients endure . We must continue to work for reform that is universal and doesn’t bankrupt families or leave patients in the often cruel hands of merciless insurance companies.” An expanded and improved Medicare for All will be far more efficient in controlling costs and will eliminates the waste that goes to insurance paperwork and profits. Let’s open it up to everyone, no one should have to wait to be 65 to be guaranteed healthcare.”

NNU continues to work at state and national levels for guaranteed healthcare. More than a dozen states have active single payer movements, and the ACA does allow state waivers to expand beyond the ACA. Nationally, nurses work with a broad array of existing healthcare and community activists to protect and improve Medicare.

For a more comprehensive list of the elements of the law, go here.