A decision last week from the U.S. Supreme Court preserved the Affordable Care Act, but much work remains to boost American health care.

In a 7-2 ruling, the court rejected a challenge to the law brought by Republican state attorneys general. The decision said the attorneys general lacked legal standing to challenge the law, sending a clear message to members of Congress: If you want to be rid of the Affordable Care Act, you will have to do it yourselves.

Republicans in Congress have claimed they desire to repeal and replace the Affordable Care Act — colloquially known as Obamacare — since the law was passed in 2010. But when they had control of the White House and both chambers of Congress during the first two years of the Trump administration, they failed to do so. And Obamacare has been in place for more than a decade without a viable alternative from Republicans.

In other words, their bluster has not been supported by action. Meanwhile, the Affordable Care Act has become entrenched and largely has worked as planned.

From 2010 to 2016, the number of Americans without health insurance fell from 46.5 million to 26.7 million. There has been an uptick since then, to 28.9 million uninsured in 2019 as the Trump administration worked to undermine the law. But public opinion polls have increasingly shown that Americans think accessible health insurance is beneficial to the country.

Some provisions of the Affordable Care Act have widespread support that transcend party lines. The act guarantees coverage for people with pre-existing conditions, eliminates lifetime caps on coverage for expensive care, and allows children to stay on their parents’ coverage until the age of 26.

Now, with the coronavirus placing a spotlight on health care, the issues are more pronounced. And they highlight the need for further action by Congress to bolster the Affordable Care Act. According to a December 2020 poll by the Kaiser Family Foundation, 48 percent of Americans support building on the act and 14 percent support leaving it as is.

Still, 44 percent of Republicans favor repealing the law. That is not going to happen, with last week’s ruling representing what likely is the last gasp of legal efforts to overturn Obamacare, and the need to expand health care remains. According to the World Health Organization, the United States ranks 37th in quality of care despite spending much more per capita than any other nation.

Sen. Patty Murray, D-Wash., has announced plans to introduce legislation for a public option — adding government-sponsored insurance as an alternative to employer-subsidized private coverage.

”A federal public option will help guarantee that no matter where you live, who you are, or what your income, if you live in America you can get the quality health care you need without worrying about cost,” Murray said.

While some Democrats support Medicare for All — a government system that would replace private insurance — such support is misguided. About half of Americans receive health care through employers, and most are happy with their coverage. Overturning that system is a political nonstarter.

But there is widespread support for a public option that would expand the marketplace and hopefully reduce the number of uninsured Americans.

As the pandemic has demonstrated, an effective health care system is essential to all Americans. With the Affordable Care Act here to stay, it is time for Congress to build on its successes rather than trying to destroy it.

The Columbian is a family-owned newspaper based in Vancouver, Washington.