The primary aim of the Affordable Care Act is to reduce the number of uninsured Americans. Even if the new federal health law accomplishes that goal, states still must grapple with the relatively high cost and low quality of U.S. health care. Per person, the U.S. spends far more than any other country on health care—and yet it gets relatively poor results for its money. It lags behind other countries on many health measures, and according to a recent report by the U.S. Institute of Medicine, about one-third of the $2.6 trillion Americans spent on health care last year paid for unnecessary procedures and avoidable hospital admissions.