Ethical Implications of the US Supreme Court Ruling on the Affordable Care Act

From its beginning, those who advocated for the Patient Protection and Affordable Care Act acknowledged that it is not comprehensive healthcare reform but a beginning toward creating a healthcare delivery system that provides access to quality healthcare for all Americans.

If nothing else, perhaps the US Supreme Court ruling provides us an opportunity to move forward on the goals of reform and will motivate us to seek common ground, demonstrating that democracy can work effectively even in a time marked by partisanship and polarizing rhetoric.

Although todays ruling by the US Supreme Court upholds one of the most controversial elements of the act, it introduces a new phase of the public debate on healthcare reform.

Hopefully, future efforts will be marked by recognition that we all bear responsibility to fix a healthcare system that is ethically flawed regardless of our political affiliation.

Significant changes have occurred in healthcare delivery since the 2010 passage of the Affordable Care Act, including eliminating pre-existing conditions as a reason for an insurance company to deny coverage and extending parental coverage to adult children up to 26 years old.

Yet the fact remains that even when the Affordable Care Act is fully implemented in 2014, some Americans will continue to struggle to receive quality care they can afford and as a society we will struggle with these same issues at a macro-level.

The court's decision today only protects the initial phase of healthcare reform, but it also magnifies the work that remains to be done to achieve the ultimate goals of healthcare reform access, quality, affordability, and justice.

For more than a quarter century, the Center for Practical Bioethics has promoted civil and reasoned discourse about the need for healthcare reform, and continue to press for a thorough examination of our societal obligations to those who are less fortunate and still marginalized by the current system.

In coming weeks the Center will promote dialogue on the ethics of healthcare reform and commentary on the Supreme Court ruling. Communication channels based on the Center's website ( will be used to examine the opinion while seeking input from the public. Bioethicists and policy experts will be available to provide perspective and comment, and a public forum on these issues will be convened in September.

Ultimately, we believe that the best interests of all will be served through civil discourse and finding common ground. Much work remains to create a healthcare system that is just and humane.

Center for Practical Bioethics

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