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As we celebrate the 14th anniversary of the enactment of the Affordable Care Act (ACA), it's a fitting time to reflect on its impact and the ongoing challenges we are still facing. I vividly remember the initial rollout of the ACA, a time when I was on the ground, working as a navigator to enroll members of the Southeast Asian community in health insurance. Those early days were marked by long hours spent enrolling individuals. Yet, the reward was immeasurable—many people were gaining access to health insurance for the first time in their lives.

Before the ACA, millions of women faced discrimination in the health insurance market. They were denied coverage due to so-called "pre-existing conditions" such as breast cancer or pregnancy. Some were charged higher premiums simply because of their gender, while others were offered limited plans that excluded coverage for their existing health concerns. The ACA changed this landscape, ensuring that preventive health care, including vital services for women, is covered with no-cost sharing.

Over the years, our systems have evolved and improved, but the work is far from over. Since its inception in 2010, the ACA has faced over 2,000 legal challenges in state and federal courts. Despite the ACA being upheld by the U.S. Supreme Court in 2021, essential components of the law remain at risk due to politically motivated attacks. The most recent challenge, Braidwood Management v. Becerra, centers on the ACA's requirement for most private insurance plans to cover recommended preventive care services without cost-sharing. This ongoing legal battle, among others, threatens access to crucial sexual and reproductive health care services.

With a more hostile and politicized judicial branch, there's a real danger that essential health benefits, including preventive health services coverage, could be eliminated. It's alarming to witness how anti-ACA, anti-reproductive health, and anti-LGBTQ+ sentiments continue to influence judges and lawmakers across the country.

These continued efforts to chip away at the health care protections in the ACA make it imperative for us to strengthen state laws that protect our care.  Here in Rhode Island, we took a significant step forward by codifying the 10 essential elements of the ACA last year. However, there's still much work to be done to safeguard access to affordable health care for all.

Now is the time for our legislature to step up and protect access to affordable, effective contraception. Bills sponsored by Senator Dawn Euer (Senate Bill 2088) and Representative Karen Alzate (House Bill 7255) aim to expand access to birth control and align state law with the ACA. Access to birth control isn't just a matter of health; it's an economic issue as well. The financial burden of birth control, with or without insurance coverage, can strain individual and family finances. The ACA provision mandating coverage of contraceptives without cost-sharing has removed a significant barrier to access.

Studies have consistently shown that improved access to birth control leads to better health outcomes for women and their families. By allowing individuals to choose the contraceptive method that best suits their needs without financial constraints, we empower them to make informed decisions about their reproductive health.

The ACA has been a game changer, but our work is far from over. We must continue to advocate for policies that prioritize access to affordable, effective health care for all, regardless of gender or socioeconomic status. Together, we can ensure that every individual has the opportunity to lead a healthy and fulfilling life.


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