If the Supreme Court overturns President Obama's health care reform law in June, Americans without health coverage may get some relief anyway—especially if they live in Rhode Island, Maryland or Oregon. These states are at the head of the pack in implementing the Affordable Care Act (ACA), and they were working to expand health coverage well before the law was passed. If the ACA is thrown out by the high court, these states—and others supportive of the law's goals—will keep pursuing reforms.