Our guest bloggers are Andrew Cray, health policy consultant for LGBT Progress, and Kellan Baker, health care analyst for LGBT Progress.

The Supreme Court’s decision on health reform concludes a tense chapter in the life of the Affordable Care Act. The lawsuit decided today challenged the constitutionality of several important provisions of the law, including the expansion of the Medicaid program to cover lower-income people without insurance.

On the issue of Medicaid, the court’s decision was mixed. Overall the court held that while states can receive federal funds to expand Medicaid coverage to all Americans under the age of 65 who make less than $15,000 per year, they cannot lose all Medicaid funding as a penalty for refusing to do so. States that expand eligibility will receive increased federal funding to cover the vast majority of the costs of covering new beneficiaries — a 2010 report projected that the expansion of Medicaid in all fifty states would cost the states $21 billion between 2014 and 2019, while the federal government would spend $443 billion. States that don’t expand eligibility will forfeit this funding and could potentially leave millions of people still without coverage.

By upholding the Medicaid expansion as constitutional, the Court’s decision leaves the door open for states to extend lifesaving access to care for an additional 16 million currently uninsured people, including many gay and transgender people and their families. Despite common stereotypes, poverty and unemployment are higher among LGBT communities, particularly LGBT communities of color, than for the general U.S. population. For example, lesbians and bisexual women are 20 percent more likely to be poor than straight women, and a recent survey indicates that transgender people are twice as likely as the general population to make less than $10,000 a year.

Additionally, without the Affordable Care Act, people living with HIV must have had a disabling AIDS diagnosis before they could qualify for Medicaid coverage. The law eliminates this requirement for states that accept new federal funds to expand their Medicaid programs.

Many experts anticipate that most states will opt to expand their Medicaid programs with the new federal funds available under the Affordable Care Act. Sara Rosenbaum, a health policy professor at George Washington University, expects “the overwhelming number of states” to adopt the Medicaid expansion. “The pressure to participate will be enormous from health care providers and communities,” she says, and “the majority of states will not want to have [their] poorest residents without coverage.”

A recent study estimated that 26,000 people die every year because they do not have health insurance coverage. While today’s decision is a major victory for gay and transgender people, there is still work to be done to make sure our communities fully benefit from the Medicaid expansion. Advocates across the country will need to work hard to make sure that their state governments do not turn their backs on those who are literally dying for coverage.

All week, anti-gay activists are “dumping General Mills” outside the company’s headquarters in Minnesota to protest its opposition to the state’s marriage inequality amendment. The protests have been dismal, with only two or three dozen people bothering to show up — even less without counting  their children. Jeremy Hooper points out now that the Minnesota for Marriage protesters are pretending to be victims as an excuse for their small numbers. Andy Parrish, Deputy Campaign Manager for the anti-equality coalition, tweeted the following today:

@generalmills VP and Head of Security’s presence at our rally to intimidate their employees from joining us ‪#stribpol‬ pic.twitter.com/FCGs9aeM

It’s unclear from this random picture who the vice president and head of security are or what it is they are doing to “intimidate” anybody. Perhaps they are sitting on the bench — how very off-putting. A legitimate group of corporate protesters would be grateful for the access and opportunity to engage with individuals in leadership positions, but apparently not Minnesota for Marriage.

Further, General Mills employees have actually taken very good care of their dissenters, offering the best in Midwestern hospitality:

Employees of General Mills responded to protesters by offering them coffee or ice water with slices of lemon. There would have been cookies too, except the protesters said they’d accept them only to add to the smattering of ‘dumped’ food they had collected. “It’s the neighborly thing to do,” Tom Forsythe spokesman for General Mills explained the unexpected hospitality. “I was raised as a Minnesotan, and when people drop by your house, you put on coffee, so that’s what we did.”

This is how the anti-gay movement works. They attempt to intimidate a company, and then claim that they are the ones being intimidated because they didn’t want cookies. It doesn’t get much pettier.

Both the Log Cabin Republicans and GOProud have responded negatively to today’s Supreme Court ruling upholding the Affordable Care Act. GOProud claimed that Obamacare “hurts gay and lesbian families” — despite the fact none of their own position statements actually support LGBT rights. LCR went a step further, with its Deputy Executive Director Christian Berle blaming Democrats for stripping LGBT-specific protections from the legislation:

BERLE: Log Cabin Republicans also have not forgotten that Democrats in Congress stripped provisions protecting LGBT families out of healthcare reform when it was passed. We remain committed to ending the Internal Revenue Service’s discriminatory treatment of employer-provided healthcare for domestic partners. While the Court may have found Obamacare to be constitutional, that does not mean it has been carved in stone. Now is the time to go back to the drawing board and institute reforms that work for all Americans.

National Stonewall Democrats Executive Director Jerame Davis told ThinkProgress that LCR has lost touch with “both reality and history”:

DAVIS: The Log Cabin Republicans must have lost their minds today. They are ignoring both reality and history in their attempt to convince LGBT Americans that the Affordable Care Act is bad for them. The LGBT provisions they claim were removed from the ACA by Democrats were done at the demands of the GOP. Throughout the healthcare debate the GOP demanded concession after concession and dug in their heels threatening to filibuster the bill in the Senate if they didn’t get their way. Log Cabin Republicans are doing a disservice to LGBT Americans by intentionally mischaracterizing the history of the Congressional debate on the ACA for partisan gain.

Indeed, even without the explicit LGBT provisions, the ACA still benefits the LGBT community in many important ways, such as improved data collection and protections for people who affected by HIV. For the Log Cabin Republicans to attack this law and the Democrats who advocated for it is to abandon support for the LGBT community just to make a disingenuous partisan cheapshot.

In a huge victory for our families, our communities, and our country, the Supreme Court today upheld the Affordable Care Act. The finding that the law is constitutional includes the individual mandate, which is the requirement that every individual have health insurance coverage or pay a small amount of additional taxes.

The court’s decision also affirms numerous other provisions that are already helping to make the insurance market more fair, expand coverage to those who don’t have it, and make it easier for gay and transgender people to get the health care they need to stay healthy.

The three major components of the law upheld by the court today are:

1. The law itself: Because the law was found to be constitutional, the justices answered the question of whether the law should be struck down with a resounding “no.” Check out some of the great things the law is already doing for gay and transgender people and their families.

2. The individual mandate: The justices interpreted the law’s requirement that every individual secure a minimum level of insurance coverage as a tax, meaning that Congress had the right to include it in the Affordable Care Act. The individual mandate pays for the law’s other health insurance market reforms – including the requirement that insurers can’t deny coverage to people with pre-existing conditions such as HIV or cancer.

3. The Medicaid expansion: The law expands Medicaid eligibility in every state starting in 2014 to everyone who makes less than $15,000 per year. According to today’s ruling, states that do not want to expand to this level of eligibility do not have to, but they will lose the new funding the law makes available for running their Medicaid programs.

The ruling is a major victory, but the road ahead to making sure gay and transgender communities fully benefit from the law is still bumpy. In particular, the expansion of Medicaid will include many gay and transgender people and their families, since discrimination in employment and relationship recognition means that they are disproportionately likely to be uninsured and to make less than $15,000 per year. Advocates in every state will need to work hard to make sure that their states expand Medicaid eligibility up to the full level the law allows.

And on July 11, the House of Representatives will make another attempt to repeal the law. But this time, the law is really on our side.

Rep. Adam Smith (D-WA)

Rep. Adam Smith (D-WA), the top-ranking Democrat on the House Armed Services Committee, has introduced a new bill that would recognize benefits for the spouses of military servicemembers and veterans. According to the bill, any marriage recognized by a state would have to be recognized by the Defense and Veterans Affairs departments:

Notwithstanding section 7 of title 1, an individual shall be considered a ‘spouse’ if the marriage of the individual is valid in the State in which the marriage was entered into or, in the case of a marriage entered into outside any State, if the marriage is valid in the place in which the marriage was entered into and the marriage could have been entered into in a State. In this paragraph, the term ‘State’ means the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, and the territories and possessions.

The question of military benefits for same-sex couples is at the heart of the case McLaughlin v. U.S. brought by eight married couples. Republican leadership in the House is defending the Defense of Marriage Act against the couples’ suit, arguing they are not deserving of equal benefits for service.