The U.S. Supreme Court finished hearing arguments for and against our nation’s landmark health reform law and now the arguments will play out behind closed doors.

As I see it, there are three possible outcomes:

  • Reform moves forward fully intact.
  • Reform moves forward without increased coverage to manage illness and care.
  • Or reform simply goes away.

America’s safety net hospitals care for the un- and underinsured and those who are simply overwhelmed by our country’s complex health care system. Nearly half the services we provide are for low-income patients. In fact, safety net hospitals represent just 2 percent of all U.S. hospitals, yet provide more than 20 percent of the nation’s uncompensated care.

Every day, we see the toll a lack of health insurance takes on Americans. We put off going to the doctor, or we prioritize other expenses over costly drugs that help manage diabetes and high blood pressure.

But safety net hospitals have developed preventive programs to improve the health of uninsured individuals, bringing breast cancer screenings to inner-city public health clinics and maintaining urban gardens for patients and communities. Read about these and other preventive programs in the Innovations section of our website.

These initiatives are part of an integrated care system safety net hospitals provide for all people every day. And these programs are why we care passionately about the Supreme Court’s decision.

It’s no secret that safety net hospitals strongly support the Affordable Care Act – including the individual mandate, which will expand insurance coverage to millions of Americans, and the expansion of the Medicaid program. While an insurance card doesn’t clear emergency rooms overnight or miraculously manage chronic diseases, it does begin to change the way we experience health care.

Health reform focuses on wellness and prevention, which is a shift in how care is delivered. More individuals and families will be connected to primary care, and hospitals will be able to better help discharged patients. Ultimately, reform will help all Americans access the services they need.

But health reform without increased coverage to manage illness and care is big talk with little to deliver.

Without expanded insurance coverage, our already stressed health care system has insufficient resources to provide preventive care and drive down readmissions. This means that patients – particularly minority and lower-income patients, who often rely on safety net hospitals for their care – will suffer.

Make no mistake. Safety net hospitals will continue to care for all patients, those with insurance and those without. But the Supreme Court’s ruling truly can help strengthen that care, and as a result, our nation’s health.