Health Care Reform: Analysis of the Supreme Court's Decision

When the Supreme Court agreed to review the constitutionality of the Affordable Care Act (ACA or the Act), many scholars, political officials, and advocates identified the case as the most important in many decades. Whether the decision announced by the Court last week lived up to the billing is difficult to assess contemporaneously. The present impact of the decision, however, is plainly significant. It let stand, at least for now, a law affecting tens of millions of Americans. And it potentially set the course of the health care sector of the economy for the foreseeable future. In addition, the Court's ruling on the Medicaid expansion in the ACA could both define the scope and determine the effectiveness of the Act. Specifically, the Medicaid holding could affect how many people remain uninsured, how many of them can access the health insurance exchanges established under the Act, and how much the reforms, as well as medical care generally, will cost.