Willard Mitt Romney has emerged as the most winsome debutante of this season’s corporate cotillion, a quadrennial bash sponsored by Wall Street tycoons, right-wing entrepreneurs, K Street lobbyists, golfers, and industrial polluters. Every four years since 1928, the big bucks boys of amalgamated power rally around some beau of the ball who agrees to insist that business acumen is the paramount qualification for election to the office of president.  

There was never much doubt that if the Supreme Court ever got a chance to decide the constitutionality of the health care reform law that it would be in for rough sledding from the court’s five conservatives. The judicial torpedoing of the law will hurt millions of poor, working-class Americans who desperately need health care, but couldn’t get affordable care before the law was passed, and are just as unlikely to get affordable care if it’s struck down. It’s no mystery who among those millions will be hurt the most.

The primary issue before the U.S. Supreme Court this week is the debate over whether the federal government can compel people to buy a product, in this case health insurance. But just as important is the secondary challenge to the Affordable Care Act’s (ACA) expansion of Medicaid to cover million of currently uninsured, low-income people. If this is upended, it could flood the courts with legal challenges to a wide range of other laws on everything from environmental protection to civil rights.

The positions of Ron Paul and other Republicans on the issue of healthcare—whether it be through the advocacy of unrealizable autonomy or the use of various red herrings—serve only as an impediment to access, degree of coverage and improvement in quality of care. The reality of attaining health insurance is not just about choice; for many, it’s about luck. Expanding healthcare coverage diminishes the unjust force luck has in each person’s life.