I am relieved that the Supreme Court decision was not to strike down only the individual mandate. Whether one likes the ACA law or not, it was predicated on a balance. Both providers and insurers are subject to provisions that are difficult (payment cuts and requirements to cover more lives).

Those provisions are only possible to sustain if there is a strong incentive for all Americans to have health insurance. Although there wasn’t a lot of discussion about the impact on providers of health care, the scenario where we would have been subject to payment penalties and still have a large uninsured population to “cover for” would have been unsustainable.

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