President Barack Obama said in his victory speech this week, after winning a second term in the White House, that the Affordable Care Act to expand health care to about 30 million uninsured people will go forward. The act was passed in March 2010 without Republican support.1

Although widespread health insurance is now a certainty for the United States, implementing the health reform act may not be smooth and easy. It will face lawsuits from groups that object to some of its provisions and objections from states that do not want to participate in parts of health reform, such as the creation of insurance exchanges …