There hasn’t been this much excitement over court proceedings since the O.J. Simpson trial and those hanging chads in Florida, and now like then there’s going to be celebrations and exasperation when the health reform decision is announced.

But even if the Supreme Court hits all the right notes in the eyes of payers and providers and allows the foundations of the bill to remain, the potential for real reform going forward is limited, and much of those limitations center around online state insurance exchanges and their myriad definitions of “essential” benefits.

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