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Dr. Gregory Coleman, Assistant Professor of Medicine, University of Miami, Miller School of Medicine, wears a stethoscope as he sees a patient on the same day that the United States Supreme Court upheld the Affordable Care Act on June 28, 2012 in Miami, Fla. - 

Jeff Horwich: Love 'em or hate 'em, you can't call 'em lazy: U.S. health insurance companies put in a tremendous amount of work for a health reform law that could have been vaporized.

Now the law's upheld, and to see how the road looks from here I've got Matt Manders. He's runs the U.S. division of Cigna -- one of the country's biggest insurers. Good morning.

Matt Manders: Appreciate it Jeff, thanks for having me.

Horwich: So was this decision by the Supreme Court just a total relief to you, or was there any part of you hoping this thing would go down?

Manders: No you know, actually, Cigna's approach about this has been really from the context of our customers. And we try to separate the political issues from what essentially is the real problem we're trying to solve, which is around giving every American the opportunity -- what they want and what they deserve -- around better and more affordable health care.

Horwich: Insurance companies like yours have been operating under a tremendous amount of uncertainty here. Had you been holding back at all in implementing this giant law, and do you need to play any catch up now that you have some clarity?

Manders: No, Jeff. Actually, the provisions of the law really started first kicking in on Sept. 23, 2010. From our position, there have been numerous compliance elements that we've needed to do the appropriate work on. So no -- we recognize that the only way that we could be compliant on time with the regulations was to work down the path assuming that the law would be upheld as it was.

Horwich: Do you really have clarity now? Republicans would still like to repeal this thing, presumably, and they might get a shot at it...

Manders: Well, I think what we have is clarity for a piece of it, which is from the Supreme Court's perspective. But as you've stated -- and I couldn't agree with you more, Jeff -- this is the final chapter of this novel. And the upcoming elections will continue to add elements of potential change or potential volatility. So, from our perspective we see it very much the way that you're looking at it and the way that you're thinking about it.

Horwich: So for Cigna customers, they're waking up today and this law is going forward. Is there anything different that they can expect from Cigna?

Manders: No. Actually, with the decision around the law taking place on Thursday, the reality is we're sending messages to our customers specifically so that they understand there will be no changes to their plans or their policies at all at this time. And that we will continue in the future to move forward, and they should expect the provisions as they're laid out in the law.

Horwich: Matt Manders, he heads the U.S. division of the health insurers Cigna. Matt thanks very much.

Manders: Thanks for having me.




Follow Jeff Horwich at @jeffhorwich