3 Recent Supreme Court Decisions and Implications for Health Equity

By Sari Bilick, Logan R. Harris, and Sukhdip Purewal Boparai

Photo by Brooke Anderson, San Francisco International Airport, January 28, 2017

Last week, Trump nominated Brett Kavanaugh, a conservative judge from the Court of Appeals DC Circuit, to replace Anthony Kennedy on the Supreme Court. It’s a painful blow to have to face another Supreme Court nomination wielded by this administration’s values — unlike with the President or Congress, we the people cannot vote Supreme Court Justices in or out.

In this post, we discuss 3 recent Supreme Court rulings which curtail our rights and set dangerous precedent for future cases. We present these as clear examples for why those of us committed to health equity must use our knowledge and voice to speak out against this nomination, based on what we’ve already learned about Kavanaugh. We also discuss the ongoing organized efforts to protect the health and well-being of those directly impacted by these 3 rulings.

Weakening the power of collective bargaining for workers via Janus v. AFSCME

The Supreme Court ruled that public sector unions can’t charge public employees an ‘agency fee’ if they refuse to join the union as full members — despite the fact the union is negotiating pay increases and benefits for them.

As the percentage of workers in unions has been declining since the 1950s, this decision further weakens the power of unions. This free-rider system will further decrease membership and financial resources of unions, which will in turn weaken the collective bargaining power of public sector unions to win strong contracts that provide fair wages, benefits, and protections for workers.

The benefits that unions bring to working people have strong links to health and health equity. Income is one of the strongest determinants of health outcomes for Americans: at every step of the economic ladder, higher incomes are associated with better health and lower risk of disease. And public sector unions have been crucial for building wealth in communities of color and creating economic security for women, especially Black women, who make up a largest percentage of government employees.

To meaningfully address health inequities, we must ensure everyone — White, Black, or Brown — has access to high-quality, well-paid jobs. Weakening unions moves our society further away from that goal.

In anticipation of the public sector union ruling (and with the reality of “right to work” laws that already exist in 22 states), union members across the country have been organizing to win strong contracts, increase their membership, and build up worker power. Only by growing and strengthening their power, workers will be able to stay strong in the face of ongoing attacks on unions.

Threatening the safety of Muslim Americans and compromising access to healthcare by upholding Trump’s travel ban

The Supreme Court upheld President Trump’s travel ban on immigrant and refugee arrivals from predominantly Muslim majority countries. In Justice Sonia Sotomayor’s dissent, she pointed out that the anti-Muslim rhetoric that Trump himself promoted and fueled throughout his campaign and presidency cannot be ignored. Hate crimes against Muslims have surpassed those of 2001, and threaten the mental and physical safety and well-being of Muslim-Americans.

In addition to instigating an anti-Muslim climate, Trump’s ban has serious consequences for health equity and health access for communities across the United States. According to the American Medical Association (AMA), International Medical Graduates (IMGs), who make up 1 in 4 of all physicians in the United states, provide healthcare to underserved communities living in poverty and rural areas through the J-1 visa program. Iran and Syria, listed on the travel ban, are amongst the top 10 countries in the world that provide medical professionals like surgeons and physicians to the US.

Creating excess obstacles for international medical professionals could mean a greater shortage of health professionals in general, and fewer healthcare resources for communities that already struggle with access to basic health care.

This travel ban hurts our fellow Muslim Americans and also hinders the healthcare system in ensuring that low-income communities receive quality and timely healthcare.

It’s critical that both Muslim communities and their allies maintain the momentum we saw in January 2017 when the travel ban was first announced. Tens of thousands of people flooded the airports to demand the immediate release of those being detained and an end to the travel ban. In times like these, this is what real solidarity and action can look like.

Allowing anti-abortion pregnancy centers to deceive women via NIFLA v. Becerra

A third key decision overturned a California law requiring that anti-abortion “crisis pregnancy centers” provide clients with information about contraception and abortion.

These centers, which often target women with limited financial resources and women of color, exist primarily to prevent women from obtaining abortions. They often use deceptive advertising to imply that they offer women a full range of reproductive health care and give misleading or false medical advice regarding abortion safety and birth control.

Reproductive justice — defined by the women of color collective Sister Song as “the right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities” — must be part of any vision for health equity.

This decision instead protects anti-abortion advocates who are deliberately deceiving and even coercing women, under the guise of legitimate medical care.

And we know that a Trump appointee is likely to continue to weaken abortion rights, meaning more women — especially low-income women — would risk injury or death from unsafe abortions, struggle to pay for abortion services, and be denied full autonomy for their own health-care decisions.

Reproductive justice advocates (who have faced threats to legal abortion for decades) constantly fight — from the courts to the clinics — to ensure that abortion is a safe and accessible option for everyone. Whether it’s escorting people to clinics, raising funds for abortion and healthcare access, or strengthening local legislation, more of us must be involved as more regulations are imposed on reproductive rights.

Our task: we must come together like we’ve done in the past

So there’s plenty to do, but there’s also plenty to build from for those of us who believe in health equity! The communities most impacted by these decisions are building community power and already using local and national organizing to brace for the consequences of Supreme Court rulings.

If we want to change the fate of generations to come, it’s critical that all of us join in these efforts and contribute in the ways we can. That will look different for each person, but there is a role for each of us.

If you want to learn more about ways to get involved in these issues, join Public Health Awakened and check out these national groups working on the issues discussed:

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