as individuals, communities, and the legislature struggle with how to provide quality health care for the many without sacrificing the basic rights of even the few. The June 2012 Supreme Court decision that upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA), first enacted in 2010, provides some guidance to states, insurers, employers, and consumers about what they are required to do by 2014, when much of the law comes into force (White House, n.d.).