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Quick Takes: Obamacare and Same-Sex Marriage are Both Public Health Issues

Supreme Court

The Supreme Court issued its rulings today in the King v. Burwell case, upholding Obamacare’s subsidies and protecting access to affordable health care for millions of low- and middle-income Americans—a major victory in the view of most public health experts.

Robert I. Field, JD, PhD, MPH, a professor in Drexel’s School of Public Health and Kline School of Law, notes:

“Had the Court ruled the other way, the law would not actually have been struck down. However, its effectiveness would have been severely limited. In the 34 states that use the federal exchange,, most people with low incomes would have found it difficult or impossible to afford health insurance. They are the people most in need of law’s help.”

Ana V. Diez Roux, MD, PhD, MPH, dean of the Drexel University School of Public Health, places the decision in wide perspective:

“All of us in the public health community are heartened by the Supreme Court decision upholding the ACA and continuing the strides we have made in increasing access to health care for so many Americans.  We know that health is affected by much more than access to medical care. But we also know that for many health conditions prompt, consistent access to to quality health care can make a big difference.  Now we must turn to the task of making sure that we as a society create and sustain the living and working conditions necessary to improve health for all.”

As Diez Roux points out, many other policies, other than those directly affecting access to medical care, have an impact on public health. And indeed the challenge to the Affordable Care Act was not the only major case before the high court this year with a significant impact on public health. Another ruling today upheld stronger rights for plaintiffs to challenge housing discrimination, and a case still pending would impact enforcement of air pollution regulations.

But perhaps the biggest Supreme Court rulings still expected this month are on the set of cases including Obergefell v. Hodges on questions of the legalization of same-sex marriage across the United States. Supporters of legalized same-sex marriage widely view it as an issue of equality and civil rights—but there is more to the story. Marriage equality also has an impact on public health.

Randall Sell, ScD, an associate professor in the Drexel University School of Public Health, is an expert in LGBT health issues and directs Drexel’s certificate program in LGBT Health. He notes:

“Legalizing same-sex marriage impacts health in a number of ways, but most importantly by decreasing stigma and discrimination which have measurable negative impacts on health. Further, same-sex marriage confers benefits such as increased access to health care. Formally recognizing relationships positively impacts social support which further improves health.”

Members of the news media interested in speaking with Field or Diez Roux about the Affordable Care Act or health policy, or with Sell about the health impact of Obergefell v. Hodges or other LGBT rights and policies, should contact Rachel Ewing, or 215.895.2614.

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