Supreme Court Justice Ruth Bader Ginsburg leaves behind a powerful legacy of establishing legal precedents that champion equality and healthcare access for all Americans. As the public mourns her passing, many are left wondering what the implications of her death might be on the American healthcare system, especially if Amy Coney Barrett, the Trump administration’s nominee, is to replace her.
This November, the Supreme Court was expected to rule on a case that seeks to dismantle the Affordable Care Act (ACA). If the ACA is repealed, American health inequity will grow: nearly 30 million Americans will lose their health insurance, and tens of millions of others may lose access to critical healthcare services. Trump’s proposed nominee is a demonstrated opposer of both the ACA and abortion—a reproductive health service that women have a constitutional right to, according to the Roe v. Wade Supreme Court decision made nearly fifty years ago.
Ruth Bader Ginsburg began her legal crusade against inequality long before she became a Supreme Court justice. She co-founded the America Civil Liberty Union Women’s Rights Project in 1971 to systematically challenge gender discrimination laws in the High Court; the project also empowers disadvantaged women through community outreach initiatives and education programs. After winning five cases before the Supreme Court, Ginsburg established herself as a thoughtful moderate during her time with the D.C. Court of Appeals.
President Clinton appointed Ginsburg to the Supreme Court in 1993. During her tenure, she set a precedent for social justice by advocating for the rights of vulnerable and disadvantaged populations. She voted that a state cannot stop a person from appealing a parental termination order just because they cannot afford to in M.L.B. v. S.L.J. (1996). In Ferguson v. Charleston (2001), Ginsburg and the Court majority asserted that it’s unconstitutional for hospitals to drug-test pregnant mothers and submit results to authorities without the mother’s consent. In her dissent from the Gratz v. Bollinger (2003) ruling, Ginsburg voiced support for affirmative action, citing the great need to eradicate racial oppression from American society. While these cases may not directly relate to healthcare, they demonstrate Ginsburg’s striving toward a more equal America in which citizens are assured certain rights.
There was one health policy issue that Ginsburg was a fervent supporter of: abortion. She saw abortion as a reproductive health service that all women have a right to, stating that “when government controls that decision for her, she is being treated as less than a fully adult human responsible for her choices.” She voted in favor of maintaining access to abortion in Stenberg v. Carhart (2000), Gonzales v. Carhart (2006), and Whole Woman’s Health v. Hellerstedt (2016).
Ginsburg further defended reproductive rights when she dissented from the majority ruling in Burwell v. Hobby Lobby Stores (2014), in which the Court allowed employers to deny employees contraceptive coverage for religious reasons. In July 2020, when the Court majority again favored religious rights over individual rights, she dissented.
Even in death, Ruth Bader Ginsburg is a force to rally behind. In the weekend after her passing, the Biden campaign received $100 million in small-dollar donations.
Ginsburg supported the ACA and its expansion of Medicaid, recognizing its importance to America’s most vulnerable populations. She believed that all Americans deserve access to healthcare because it is their right.
The Trump administration has already obstructed Americans’ access to healthcare by dismantling parts of the ACA, even amidst a global pandemic. In 2019 President Trump attempted to block legal immigrants from entering the U.S. if they didn’t have healthcare. Recently, he has expressed his opposition to abortion access. His Supreme Court nominee Amy Coney Barrett also opposes the ACA and abortion access.
If Ginsburg is replaced by Amy Coney Barrett, the Supreme Court will be majority conservative. Their November ruling on the ACA might scrap parts of the current healthcare system, or it could be thrown out completely. If the latter occurs, tens of millions of people will lose healthcare coverage. Fewer people will be eligible for Medicaid, Medicare premiums will be more expensive, and drug prices could increase. Private health insurers will no longer be required to cover adults or children with pre-existing conditions. Preventive healthcare services, including screenings, contraception, and immunizations may no longer be free, or covered at all. These effects will exacerbate health inequity in America.
Aside from the effects of repealing the ACA, Amy Coney Barrett could impact abortion legislation (especially as states like Louisiana and Georgia have attempted to establish restrictions on this health service). This is a social justice issue: making it harder for women to get abortions is a violation of their reproductive rights.
Similarly, Amy Coney Barrett’s position on climate change could result in legislation that reduces fossil fuel regulation. Worsening floods, heat waves, and storms will hurt American health, especially disadvantaged and vulnerable populations.
While the effects of a conservative majority Supreme Court may be alarming in the context of healthcare, take heart. Find empowerment in Ruth Bader Ginsburg’s life spent fighting for social justice: let your voice be heard by voting in this year’s election.