As we collectively mourn the loss of Supreme Court Justice Ruth Bader Ginsburg, we at NoHLA are reflecting on her role as a fierce champion for equity, justice, and human compassion. As a lawyer and a jurist, her trailblazing work has advanced the causes of access to health care, reproductive rights, civil rights including for those with disabilities, and many others.  She also stood firm when she was in the minority on the Court, with “her fiery dissents, pulling no punches as she called out her colleagues’ egregious opinions on access to contraception, fair pay, and a host of other issues.” (-Nan Aron, President, Alliance for Justice) 

In the words of Community Catalyst Executive Director Emily Stewart, Justice Ginsburg “served our country valiantly by committing her life to justice and using her position to stand up for those who are excluded from our democracy. Her leadership on the high court has had a profound impact on people’s ability to control their own bodies and lives regardless of who they are, where they live, or how much money they make. Justice Ginsburg’s legacy will not be forgotten. We mourn this loss for our country, but as health advocates, we will carry her legacy forward in the fight for justice.”

We must now prepare for the fight ahead to honor that legacy by turning our grief into action to protect the health care rights of Washington State residents and people throughout the country. There is much at stake in the coming months as President Trump and Senate Republicans consider filling the Supreme Court vacancy: 

• ACA coverage protections. On November 10th, the Supreme Court will hear California v. Texas, a case that could determine the fate of the Affordable Care Act’s health coverage expansions to more than 20 million Americans. The Court will consider a lower court decision that would invalidate the ACA in its entirety. Though legal scholars widely agree the lower court decision is baseless, it is possible the Supreme Court could invalidate the ACA in some scenarios, such as if the Senate fast-tracks a Trump appointment or if there is a 4-4 split in the remaining members of the Court. Though the Court will not reach a decision until mid-2021 and there may be even more litigation to follow, the potential consequences of the decision are far-reaching: if the Court’s ruling invalidates key ACA programs and protections like the Medicaid Expansion and coverage for those with pre-existing conditions, the number of uninsured people in Washington State could double. 

• Nondiscrimination in health care. With Justice Ginsburg on the Court, the Supreme Court had recently acted to maintain women’s equal access to abortion care (June Medical Services v. Russo) and extend certain federal nondiscrimination protections to LGBTQ+ people (Bostock v. Clayton County). Now there are critical cases in the lower courts that may ultimately end up at the Supreme Court, such as cases regarding the ability of health care providers to decline to provide care for abortion or LGBTQ+ individuals. 

• Equity in Medicaid Access. Court-watchers also predict that critical cases related to access to Medicaid may end up on the Supreme Court docket in the coming year. There is litigation pending in the lower courts over the federal “public charge” rule, which aims to curtail access to Medicaid and other benefits for some lawfully-present immigrants, as well as federal agency action that could allow states to impose “work requirements” as a condition of Medicaid access. These harsh rules, which have a disproportionate impact on communities of color, may make their way to the Supreme Court as soon as this year.  

NoHLA will be vigilant in monitoring and sharing information about these cases as they unfold. While there is no change to health care for Washington residents at this time, Justice Ginsburg’s passing leaves the fate of critical health care programs in the balance. 

Remarking on Dr. Martin Luther King, Jr.’s adage that, “The arc of the moral universe is long, but it bends toward justice,” Justice Ginsburg suggested an addition: “if there is a steadfast commitment to see the task through to completion.” In memory of Justice Ginsburg, NoHLA will be here to see the task of health care justice for Washington residents through. It is important for all of us to follow her example and stay engaged to make the world a better place.

– Emily Brice, NoHLA Senior Attorney and Policy Advisor