Opinion: A moderate ruling with risks ahead

There is no underestimating the importance of the Supreme Court decision upholding most of the health reform law—politically, constitutionally and in terms of its practical effects on the nation and the economy. These effects were clear from the moment the decision was announced Thursday morning, but the constitutional picture was more complex. The major exception to the strong legal endorsement of the law involves Medicaid. We disagreed with the court's legal reasoning on this point and believe that without the possibility of withdrawing federal funds, the reform law may fall short of ensuring near-universal coverage.