In the midst of a pandemic and with the fate of the Affordable Care Act pending before the Supreme Court, attention should focus on what Justice Ginsburg’s replacement by someone who is likely to be very conservative will mean for health care. Justice Ginsburg was a strong voice and a consistent vote to provide the federal government the power to ensure health insurance for all and especially to protect women’s reproductive health.

The Supreme Court first assessed the constitutionality of the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius (2012), a few months before the 2012 presidential election. One aspect of the ACA that was challenged was the so-called “individual mandate,” requiring individuals to purchase health insurance or pay a special tax. The requirement was designed to prevent a downward spiral on the health insurance market if only sick people were enrolled (thus raising the