President Barack Obama speaks at the White House after the Supreme Court ruled on his health care legislation. (Luke Sharrett/AP)

Though an obvious coup for the millions of uninsured and underinsured Americans, this is a broader victory for the American people, especially for struggling American families. More than 26,000 working-age adults die prematurely in the U.S. because they lack health insurance, according to a study by Families USA, a liberal think tank that advocates for heath care reform. We can hardly call ourselves a truly developed nation and leaders of the free world when so many of our citizens have been bankrupted by medical expenses, and scores are left to die due to lack of medical coverage. 

For those who want to criticize Obama or the Supreme Court for over-reaching, such a high mortality rate from lack of access to medical care, is a statistic that’s truly “third-world.” It places us far behind other industrialized nations in terms of caring for our citizens.  Many uninsurable Americans, or those too rich to qualify for Medicaid, yet too poor to afford private health insurance, may rightfully feel no better off than those in blighted and embattled countries our leaders routinely insist upon nation- building.  If we can nation-build abroad with our tax dollars, then we are certainly morally obligated to use our considerable resources to nation-build here, by providing our citizenry affordable and accessible health care.

From major cities to small towns, health care disparities loom in our nation.  We currently have thousands of people languishing on waiting lists for AIDs medications they can’t afford—un-medicated and more infectious, they are more likely to infect their partnes.  Women are routinely denied preventative care such as mammograms and pap smears due to insufficient medical coverage.   People are dying in emergency rooms—very costly economically to our nation—of advanced diseases because they cannot afford preventative care.  With the fundamental change of our employment paradigm—with more workers contracting or underemployed and less employers providing comprehensive benefits—health care coverage  is no longer employer-based and not easily and affordably portable. 

Indeed, the Supreme Court’s decision was far from a political one—it was a practical decision of conscience to find legal justification to uphold the Affordable Health Care Act under Congress’ tax and plenary powers. It ensures Americans access to affordable health care that for so long has been denied.   

Cost-effective and accessible health care, the capstone of Obama’s progressive domestic agenda, is a political accomplishment which will resonate for generations.  Though short of universal health care with a public option some had hoped for, this is the “yes we can” Obama that captivated and enthralled the nation in 2008.  Instead of fighting against much-needed “progress” and “change” in the provision of health care to Americans—key to our nation’s stability and economic growth—the detractors of Obama’s affordable health care act should work to build upon its intricacies to further expand and ensure comprehensive health services to all Americans. 

In this great nation of wealth and opportunity—of exceptionalism personified by Obama’s meteoric rise from humble beginnings—no person should perish because of lack of access to the abundant medical advances and technology we have the brain power to innovate.  Adequate health care is a fundamental human right.   If a government’s primary, and some would argue only responsibility, is to protect its citizens, then the Supreme Court’s ruling in support of health care reform certainly embodies such a lofty goal.

Joy Freeman-Coulbary, a Washingtonian, is a pacifist, lawyer and blogger. You can reach her at and follow her on Twitter @enJOYJFC.