On May 5, I joined Dr. Claudia Baquet and other notables to celebrate the 75th anniversary of the Journal of Health for the Poor and Underserved. We came together to share our practical and moral assessments of the Affordable Care Act (more widely known as “ObamaCare”). For those of us who were strong advocates for the enactment of ObamaCare – and who now are the frontline defenders of healthcare reform – our moral position is clear.

Human beings in any truly civilized society deserve affordable health care. We deserve that care when we are in need and regardless of our stations in life. In short, as Americans, affordable health care is our right, not merely a privilege to be enjoyed only by some.

Admittedly, the initial implementation of the ACA’s national and state-run healthcare exchanges was not without its challenges. Now, however, those initial technical obstacles are being overcome, and we are beginning to witness the new law’s potential to save lives. More than 8 million Americans signed up for private insurance plans through the federal and state exchanges during the first open enrollment season, many receiving subsidies to lower the cost of their insurance. Millions more are benefitting from expanded eligibility for Medicaid.

ObamaCare is changing the trajectory of people’s destinies – just as it was designed to accomplish. Under the prior health insurance system, the evidence confirmed that between 18,000 and 50,000 Americans were dying prematurely each year because they lacked health insurance. They died because they did not receive the care that they needed when it would have prolonged their lives.

One study, by the Public Library of Science, revealed a 33-year difference between the longest and shortest living groups in our country. The healthiest Americans were setting the upper curve for global life expectancy, while those on the lower rungs of our society had life spans comparable to individuals in developing nations. Morally, that contrast is appalling, demanding urgent reforms. It is a life-or-death reason why healthcare can no longer be viewed as a privilege.

Moreover, even for those of us who have survived serious injury or illness, health-related expenses have all too often been financially crippling. Americans have found themselves unable to work, facing ever-growing medical bills, and suddenly unable to pay for life’s necessities.

Forthrightly stated, I consider ObamaCare to be a significant down payment upon the transformative change that everyday Americans need. I continue to believe that, eventually, only a single-payer system based upon Medicare will allow us to insure everyone while we also constrain rising healthcare costs. Still, as a member of Congress and advocate for Americans of modest means, I was driven by a sense of urgency to establish affordable healthcare as a right.
That is what the Affordable Care Act accomplished.

Because of the ACA, more than $11 billion in federal grants to community health centers will effectively double their ability to serve patients in underserved communities. Because of the ACA, American children no longer need to worry about being pushed off of their parents’ plans and losing coverage. Because of the ACA, a pre-existing condition no longer excludes us from coverage – and lifetime and yearly limits on healthcare coverage will no longer be tolerated.

Because of the ACA, many preventive care procedures are now free; and seniors are receiving annual discounts on their prescription costs.

To be clear, as someone who has fought against healthcare disparities throughout my professional life, I realize that access to affordable health insurance is not the only force that is shortening our lives. Nevertheless, as a mortality factor, access is critically important.

Although we are making progress in our movement to eliminate that deadly factor by transforming affordable healthcare from a privilege into a right guaranteed by federal law, the political struggle continues.

Tragically, the Republicans’ relentless campaign against the Affordable Care Act and President Obama has limited the expansion of healthcare coverage in places where it is needed the most. Especially appalling are the 24 states that have failed to expand Medicaid coverage. For political reasons, those Republican-led states have elected to forego the billions in federal funds that could be helping 4.8 million Americans who would qualify for Medicaid under the ACA’s expansion. In Texas alone, more than 1 million additional residents could access Medicaid benefits if coverage were expanded. Consider this. If all states expanded their Medicaid programs, almost 80 percent of the 41 million Americans who currently are uninsured would be able to purchase coverage for $100 or less per person, per month.

Lives are in the balance, and the political struggle to repeal ObamaCare is intense. As a nation, we have a choice to make. Either we can return to a broken system that allowed premature death and financial devastation – or we can choose life.

U.S. Rep. Elijah Cummings represents Maryland’s 7th Congressional District in the United States House of Representatives.