After the U.S. Supreme Court affirmed the bulk of the Affordable Care Act (ACA), several significant issues have been squarely deposited into the laps of the states, and they will need to act relatively quickly to resolve them. To be sure, legislative efforts to repeal, modify, or defund the ACA or various aspects of it will continue apace in Congress due to the partisan rancor over national health reform—a divide that was not bridged in the slightest by the Court’s ruling. In fact, in mid-July, the House of Representatives voted again to repeal the ACA outright, but that bill will go nowhere in the U.S. Senate.
