The Legacy of Justice Ginsburg and Why We Must Protect the ACA.

Protect Our Care Illinois joins the millions of health care advocates mourning the recent loss of U.S. Supreme Court Justice Ruth Bader Ginsburg. In addition to being a champion for women, LGBTQ+ communities, and immigrants, Justice Ginsburg was a monumental figure in the fight for equitable, affordable health care coverage for all. 

As we look back on the legacy of Justice Ginsburg, we also look to the future. The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this November in the Health Care Repeal lawsuit (California v. Texas). Justice Ginsburg was anticipated to use her vote in defense of the ACA; now Protect Our Care Illinois joins health care justice advocates around the country to sound the alarm about what her vacancy means for the future of the ACA. In the midst of an increasingly severe public health crisis and the biggest economic downturn in recent history, the stakes could not be higher.

Since the passage of the ACA, over 20 million individuals, children, and families have gained access to comprehensive health care. In addition, the law has led to historic reductions in racial inequities in access to health care. Between 2013 and 2018, the uninsured gap between Black and white people closed by 4.1 percentage points and 9.4 percentage points between Latinx and white people. Both historical and contemporary U.S. policies, including welfare policy, disproportionately harm Black, Indigenous, and other people of color, as well as immigrants. The lack of universal health insurance coverage is very much a part of the racism and xenophobia expressed through policy [1], [2].

The law also pioneered meaningful access to health coverage including ensuring coverage for 135 million Americans with pre-existing conditions; the expansion of Medicaid eligibility for adults with low-incomes; required coverage of preventive services with no cost-sharing in private insurance, Medicare, and for those enrolled in the Medicaid expansion; and allowed young adults 26 and younger to remain covered by their parent’s health plan. The ACA also took radical steps to protect and expand the health rights of women, HIV/AIDS, and LQBTQ+ communities. Simply put, the law significantly moved the needle on accessible and equitable health care.

If the ACA is overturned over 800,000 Illinoisans could lose coverage, with over 600,000 adults losing coverage gained through Medicaid expansion, alone. Across the state, over 5.4 million people with pre-existing conditions could lose guaranteed coverage – including anyone who has tested positive and/or has been treated for COVID-19. Health plans could once again start imposing limits on lifetime coverage, routinely charging women and older adults more for care, and lift caps on out of pocket costs to consumers. 

While more is needed to reach equitable health care for all, the ACA made significant progress on reducing health care disparities. Protect Our Care Illinois refuses to allow the reversal of this progress. As health justice advocates we will continue to educate and activate our communities in opposition to the Health Care Repeal Lawsuit. 

Join our efforts to save the ACA! Below are some ways that you can engage in this fight to protect people’s health care!

  • We encourage everyone who has been impacted by the ACA to share their story via social media using #SaveOurHealthcare and #ProtectILCare
  • Thank our elected officials for their tireless defense of the ACA, including: Illinois Attorney General Kwame Raoul (@KwameRaoul); Senator Dick Durbin (@SenatorDurbin); and Senator Tammy Duckworth (@TammyforIL).
  • Join Protect Our Care Illinois’ ongoing efforts to defend the Affordable Care Act by contacting