Today, we witnessed  one of the most important U.S. Supreme Court rulings in decades: In a 5-4 vote, the Affordable Care Act was upheld, including the mandate that would require most Americans to sign up for health care by 2014 or pay a tax.

Back in March, I wrote specifically about why this piece of legislation is very important to African-Americans. According to the White House, 21 percent of African-Americans were uninsured in 2009, and 20 percent of all African-Americans did not have a regular doctor, compared to 16 percent of whites; African-Americans are more likely to develop and die of cancer than any other racial or ethnic group; and African-Americans were diagnosed with AIDS at nine times the rate of whites. Also, African-Americans are more likely to use the emergency room as a regular place of care compared to whites and African-Americans are more likely than both their white and Latino counterparts to report delaying or forgoing dental care and prescription drugs.

The ACA's goal is to lessen those and other disparities by expanding health care coverage to the 30 million Americans who are not insured.

Under the ACA, starting in 2014, it will be illegal for insurance companies to deny coverage because of a pre-existing condition. The ACA also makes it possible for you to attain preventive services such as cancer screenings, HIV tests, mammograms and Pap smears without incurring a co-pay or fees toward your deductible; it continues your health care even if you have lost your job; provides young people the ability to stay on their parents’ insurance policy until the age of 26; and decreases costs for seniors on Medicare.

But with today's ruling comes a catch.

Expanding Medicaid, a government-issued insurance for low-income and disabled Americans — must be based on a state's willingness to do so, not Congress forcing them to do so. Some health advocates fear that if states refuse to expand Medicaid, less people will have insurance, which goes against the very mission of the ACA.

"This is not a complete victory, because today's decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it," says Scott Schoettes, HIV Project Director for Lambda Legal.

And while we hope that states will do the right thing, there is this underlying fear that the people who will suffer the most from this are people of color and low-income folks who live in states with conservative governments, such as those in the South. Think about it: In this region, we see growing and alarming epidemics such as obesity, diabetes, STDs, HIV/AIDS and heart disease to name a few. Without preventative care and treatment, people's health will only worsen.

So in the end, we should celebrate all who will gain health care or have stronger existing health care because of the ACA. But it's important to not lose sight of the millions in the U.S. that will go without.

Hopefully Congress realizes that the battle for better health for all isn't really over.

The opinions expressed here do not necessarily reflect those of BET Networks.

BET Health News - We go beyond the music and entertainment world to bring you important medical information and health-related tips of special relevance to Blacks in the U.S. and around the world. Click here to subscribe to our newsletter.

(Photo: Mark Wilson/Getty Images)