The Affordable Care Act status quo has been affirmed by the Supreme Court, but this doesn’t mean that it has been rescued. While subsidies will continue flowing to federal exchanges, significant challenges remain: A lack of patient-friendly information on the exchanges along with the growing threat of hospital monopolies that can drive up costs will cause new headaches for people enrolling on exchanges. Addressing these problems will require conservative reformers to take a step back and work with local policymakers to help enable constructive but powerful changes to the law.

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