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Supreme Court Rules Affordable Care Act Constitutional

Greater access to healthcare for LGBT Americans
In a narrow 5-4 ruling, the Supreme Court found the Affordable Care Act—and its controversial expansion of health insurance coverage to nearly all Americans—largely constitutional. The decision represents a resounding victory for President Obama and Democrats in Congress, who passed the Affordable Care Act in 2010 over vehement opposition from Republicans.

[The Supreme Court has] reaffirmed a fundamental principal: that here in America, the wealthiest nation on earth, no illness or accident should lead to any family’s financial ruin,” the president said at mid-day. “Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.”

Tens of thousands of uninsured or underinsured LGBT Americans, as well as those already covered, will benefit from the Affordable Care Act’s provisions, according to a report co-authored by the Center for American Progress and the National Coalition for LGBT Health. Lesbian, gay, bisexual and transgender people face a stacked deck of obstacles to affordable, quality healthcare while suffering certain diseases and conditions at a higher rate than the general population. For example, lesbians experience higher rates of breast cancer, skin cancer, non-Hodgkin’s lymphoma, and smoking and obesity related diseases. Yet LGBT people are twice as likely to be uninsured as non-LGBT Americans. Gay and lesbian workers can be fired for their sexual orientation in 29 states, and lose their employer-provided health insurance along with their jobs. Most states don’t recognize same-sex relationships, barring spouses from obtaining health insurance coverage on one another’s plans.

The Affordable Care could change the lives and wellbeing of thousands of LGBT people in several ways, such as:


  • extending federal nondiscrimination protections on the basis of sex to the health care system for the first time

  • requiring everyone to obtain health insurance, either through private plans or through state-run programs that provide coverage based on income for those who can’t afford private insurance

  • preventing insurance companies from rejecting patients based on pre-existing medical conditions

  • requiring state-sponsored plans to provide coverage for “minimum essential benefits,” such as mental health care, preventive services and prescription drugs

  • funding community health centers to provide culturally competent care

  • prioritizing participation of people of “different genders and sexual orientations” in mental health training and education programs


LGBT groups enthusiastically applauded the court’s ruling as a decisive step forward for LGBT rights.

This ruling is a victory for millions of people—including LGBT people and our families—who don’t have access to adequate, affordable health care. It is based on the premise that no one get hung out to dry, to literally die in some cases, because they were denied affordable health care in one of the richest countries in the world,” said Rea Carey, executive director of the National Gay and Lesbian Task Force. “It also reminds us of the work that remains to be done. We continue to press for reform that addresses the stark realities that many of us face every day.”

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