Last week, Americans watched as the new Republican majority in the U.S. House of Representatives began a concerted effort to destroy one of President Obama’s signature initiatives – The Affordable Care Act. We need to be clear about all that is at stake.

Every senator and representative has been educated about the mortal consequences of our flawed health care system, so none of us can plead ignorance as an excuse.

When we look deeply into our hearts, we know that even one death that could have been prevented would be unacceptable. Yet, the harsh reality that we are struggling to overcome is far worse.

The National Academy of Science’s Institute of Medicine has been informing us for some time that at least 18,000 Americans die every year because they lack the affordable health insurance that could have allowed them to survive.

When I speak to opponents of The Affordable Care Act, I tell them of the neighbors I see every day who are walking around with cancer – and must choose between feeding their families and the treatment they need.

In response to my testimony, all too often, the health care opponents’ eyes glass over. As scripture tells us, their “hearts have become hardened.”

Nowhere in America is the “butcher’s bill” from our flawed health care system worse than in minority communities. That is why we must not allow the suffering in our midst to become lost in a blizzard of statistics and competing claims.

As Dr. Lesley Russell observed in a recent monograph for the Center for American Progress, “The Affordable Care Act will improve health coverage and access to health services for all Americans, especially for people of color.”

Her article summarizes what so many African Americans already know from our own lives.

Currently, racial and ethnic minorities make up more than one-half of America’s uninsured. Without The Affordable Care Act, we will continue to be more likely to be denied adequate health insurance coverage and continue to have higher rates of infant mortality, disease and disability.

Without substantial reform, we will continue to be less likely to receive the life-prolonging benefits of preventive health screenings, regular health care and necessary medications that can prolong our lives.

To be certain, arguments about the impact of The Affordable Care Act upon jobs and our national budget are relevant. Personally, I am convinced that supporters make the better case.

For me, however, there is a larger, more compelling question – and a far more clear-cut answer.

Our ongoing debate about universal access to high-quality, affordable health care comes down to a straightforward moral determination.

What value will we, as a society, decide to place on saving a human life?

In the resolution of this fundamental, moral debate, America’s minority citizens must remain unafraid to lift our own voices about the critical importance of reform in our own lives.

As most Americans realize, the objective of our legislation is to expand health coverage to at least 32 million people who currently have no insurance, providing financial assistance to help those with lower incomes purchase their coverage.

Although our strategy is being implemented over several years, I am deeply gratified that our progress toward this goal is already being felt in our community.

More children are being insured; our seniors are receiving free preventive care and facing a smaller “donut hole” in their prescription coverage; insurance plans for the uninsured with pre-existing conditions are being provided; young people are now able to stay on their parents’ insurance until age 26.

Fewer people with insurance are seeing their insurance canceled when they get sick – and the annual and lifetime limits on coverage are being eliminated.

We also are determined to expand access to the primary care and medical homes (including federally qualified health centers) that can better ensure a regular source of care.

In the ongoing national effort to eliminate racially based health disparities, I was proud to have contributed personally to placing the Office of Minority Health within the Office of the Secretary of Health and Human Services.

The Affordable Care Act includes many more examples of constructive change, but the moral boundaries of this health care debate should now be clear for all to see.
As President Obama once observed, “It’s about what kind of country want to be.”

Congressman Elijah E. Cummings represents Maryland’s Seventh Congressional District in the United States House of Representatives.