Today’s Supreme Court decision is a victory for millions of Americans who have gained health insurance under the Affordable Care Act and who are at reduced risk of losing everything to the physical and financial costs of the injuries and illnesses we all experience. In this way, today’s decision promotes effective public policy against homelessness.
However, the ACA remains needlessly complex and leaves millions of Americans without health insurance or severely underinsured and at risk of homelessness. Today’s decision sustains a complex and confusing set of systems with multiple layers of unproductive and costly bureaucracy. Opponents of expanded coverage will surely find in this morass other avenues of attack through the courts. Ultimately, the inefficiencies, costs and coverage gaps of the ACA framework will not be sustainable when compared to alternatives found in every other industrialized democracy with universal systems designed to bring everyone in and to leave no one out.