Most medical leaders in our area say the Supreme Court decision on the Affordable Care Act was a good one. They say work will now have to be done to find ways to pay for it and to keep health costs down in general.

Peter Robinson, the University of Rochester Medical Center Chief Operating Officer, says it's good news because millions of uninsured Americans will now have coverage. Just at Strong and Highland alone, the uninsured cost the medical center $70 million a year in charity care.

"It's also good news because it provides predictability in terms of where things are going,” Robinson said. “We've been working on implementation of the health reform bill since it was passed in 2010. The main provisions will be implemented in 2014. So we are on a path to getting ourselves ready for that."

Robinson says New York has been ahead of the curve with some of the provisions of the act, like covering young adults under their parents’ policy up until age 26, already in place here before 2010. He also said the URMC is looking at the issue from both sides of the coin, both as medical care providers and as employers themselves.

"We're very anxious to drive health care costs down. We think it's the right thing to do for consumers. You should know that this community is really advantaged nationally, we are a much lower cost health care community than most others in the country,” Robinson said.

"Overall impression... no big surprise,” said Sandy Parker.

Parker, the Rochester Business Alliance CEO, says the biggest question about the Affordable Care Act has been whether or not employers can afford it.

"No one can argue with the benefits of having everyone have health insurance, but the question, the issue that's not been addressed, is how are we going to pay for it. Employers are increasingly worried that this is going to be an extra burden on them,” Parker said. “Employers in this region, we regularly survey them, say health care costs, particularly small employers, say health care costs, are eating up more and more of their operating budgets."

Parker says most will now watch and see what will happen once those other provisions kick in in a couple years.

In the meantime, the URMC says it's now also going to focus time and effort in preparing more primary care doctors, who are expected to have a tremendous influx of newly insured patients.

"What we're looking to do is insure that we can continue to grow the primary care base here. That's a critical issue for us as a community. That means training more people,” Robinson said.