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Will health care reform be good for the U.S. economy?

Carlos Ayala, 15, whose family doesn't have health insurance, receives a physical examination in Miami, Fla. Thirty million Americans are currently uninsured.

Kai Ryssdal: Now that we've had time to digest the ruling this morning from the Supreme Court, things are a little more clear than they were in all that analysis you heard, oh, a nanosecond after the decision was handed down.

The individual mandate survives -- the requirement that everyone buy health insurance -- provided you call it a tax, Chief Justice Roberts said. There's a Medicaid part of the case that the states are going to have to deal with. We'll get to that a little bit later in the program.

But we begin today with this. Now what happens? Health care's 20 percent of the American economy after all, and you can't make the kinds of changes the Affordable Care Act makes without some trickle-down effects.

Marketplace's David Gura gets us going today on health care and the Supreme Court.


David Gura: Thirty million Americans who currently don’t have health insurance are expected to get it, and that’s 30 million new customers.

Henry Aaron is with the Brookings Institution, and he says that could be a boon to insurers, and it is also good news for doctors and hospitals.

Henry Aaron: It’s not ghoulish. You want your beds filled, because that’s the way you stay in business.

But what’s good for the health care industry isn’t necessarily good for the rest of the economy. John Engler heads the Business Roundtable, and he says that while today’s ruling eliminated some uncertainty -- about the legality of the law -- a big question remains:

John Engler: How do we get a health care system that, for America, doesn’t continue to cost more and more each year?

Over the coming decade, health care costs are expected to grow to a fifth of our GDP. One goal of this law was to improve access to health care, and another was to improve the quality of health care.

Jonathan Oberlander teaches public health at UNC, and he says the Affordable Care Act doesn’t do much -- at least not explicitly -- to bring down costs.

Jonathan Oberlander: Containing health care costs is the hardest task politically, because cost control is really income control to the health care industry.

And it’s an industry that has been pretty much recession-proof -- it’s one of the only parts of the economy creating new jobs.

Allison Hoffman teaches law at UCLA.

Allison Hoffman: It has been an engine for economic growth for a number of years now.

When costs go down, that benefits the customer -- the patient -- Oberlander explains, but it doesn’t benefit everybody.

Oberlander: The law adopts a lot of different strategies that could control costs, but we don’t know that they will, and my own guess is we’re going to need to strengthen those cost-containment provisions down the line.

And because the whole law hasn’t been implemented, and because the Affordable Care Act could be amended or changed, business groups say they’re still concerned.

Neil Trautwein is with the National Retail Federation.

Neil Trautwein: We are still waiting for final regulations on a short timetable towards 2014, when a lot of this stuff becomes fully applicable.

And there is one huge uncertainty looming before 2014: Who wins the elections in November.

In Washington, I’m David Gura for Marketplace.

About the author

David Gura is a reporter for Marketplace, based in the Washington, D.C. bureau.

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