People rally to protect health care reforms on March 26 outside the Supreme Court as it hears arguments on the health care act.
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People rally to protect health care reforms on March 26 outside the Supreme Court as it hears arguments on the health care act.

Story highlights

Melody Barnes: "Repeal and replace" health care act critics offer no alternative

Barnes: The law prevents "pre-existing condition" refusals and lifetime caps on coverage

Barnes: Law offers access to mammograms, colonoscopies; diabetes and cholesterol tests

Lower federal courts, with judges of both parties, found the law constitutional, she says

Editor’s Note: Melody Barnes is the former director of the White House Domestic Policy Council and CEO of Melody Barnes Solutions LLC. She was also executive vice president for policy at the Center for American Progress, and led the center’s faith and progressive policy initiative.

CNN —  

I know what relief looks like.

Not long after the Affordable Care Act became law, I saw it in the eyes of a friend. We’d said goodbye in her office, so I was surprised to hear her calling my name as I flagged a cab. But standing in the cold, she explained that health insurance for her toddler had been elusive because of a pre-existing condition; she wanted to know if it was true – did the reform bill mean she could get insurance for her child?

I assured her that it did, and then I saw it. Relief. A burden removed.

Millions of people have had that same experience in the past two years. Because of the reform law, the worst insurance company abuses are over. The Affordable Care Act will end the practice of charging women 50% more than men for the same coverage. By 2014, the same prohibition that now prevents insurance companies from denying coverage to children with pre-existing conditions will extend to adults.

Melody Barnes
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Melody Barnes

And it’s illegal for an insurance company to impose a lifetime cap on coverage and toss people out of the health care system at the very moment they may need it most. About 105 million people had lifetime caps, and 20,000 people hit the cap every year. But now that threat is gone, and families – like my friend’s – have a sense of relief.

But in addition to helping the sick get well, the Affordable Care Act helps prevent the healthy from becoming sick. At least 86 million Americans have benefited from free preventative care, and that means that 32 million seniors – almost three-quarters of those enrolled in Medicare – got a free service in 2011.

It means that 54 million people with private insurance, including over 20 million women, had access to critical mammograms and colonoscopies, as well as tests for diabetes and high cholesterol. It means that African Americans who suffer with high blood pressure at rates much higher than other communities can prevent disease before it starts. It means that Latinos who are more likely to develop cervical cancer and less likely to be screened for colon cancer can get the tests they need to catch these diseases early.

And for those young adults who often bet on invincibility – unable to afford insurance as they enter the workforce – the Affordable Care Act means they no longer have to worry about coverage if their luck runs out. Young men and women can stay on their parents’ insurance until they turn 26, and 2.5 million who would otherwise be uninsured have done just that, including 1.3 million young people of color.

Opinion: Why the health care reform law is unconstitutional

Life before and after the Affordable Care Act is different. And the good news is that health care for Americans will only improve. In 2014, every single American, regardless of circumstances – whether they want to change jobs, start a business, or even if they lose their job – will have access to affordable, quality health insurance. For 70 years, presidents have tried to improve our health care system. President Obama did it.

And yet, this week, the threat to these reforms is evident. Many Republicans – led by those contending for their party’s presidential nomination – are chanting “repeal and replace” as the Supreme Court hears arguments questioning the constitutionality of the Affordable Care Act.

The chant is more a bumper sticker than a serious plan to address America’s health care crisis of rising costs and uneven access. Not only are Americans opposed to repealing the law, but the head “repeal and replacers” don’t have a credible alternative to put in its place.

The challenge to the law that is before the Supreme Court is a clear and present danger to both a well-reasoned understanding of the Constitution and good policy. While the key issue at the heart of the debate – the constitutionality of the individual mandate – wouldn’t touch the lives of the vast majority of Americans who already have insurance coverage, it is a critical element of the law if we’re going to lower costs and ensure that those with pre-existing conditions get the help they need.

Everyone has to be in the pool. Unfortunately, smart policy sometimes falls victim to constitutional arguments – remember campaign finance reform.

For that reason, proponents and opponents of the law watched Tuesday and Wednesday’s arguments before the court with great interest – and the usual armchair quarterbacking commentary and crystal ball gazing predictions. In spite of the sound and fury, no one really knows what the outcome will be.

We do know that the justices often aggressively challenge the lawyers before them, and that challenging might have little bearing on the ruling. It’s important to remember two things. First, the majority of lower federal courts – including judges appointed by Democrats and Republicans – have found that the law sits within the boundaries of the Constitution. And second, conservative judges who sit on those courts and ultimately supported the law were sometimes the harshest questioners.

The Affordable Care Act is helping individuals and families and our economy. Once the chanting is over and the Supreme Court has ruled, the good work must go on.

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The opinions in this commentary are solely those of Melody Barnes.