Associated Press
FILE - In this April 5, 2009 file photo, the Department of Health and Human Services building is seen in Washington. Really? The Supreme Court's big health care decision means 30 million or more uninsured Americans are soon going to have coverage? It's far from that simple. The ruling points a way forward for millions who can’t get affordable coverage because they’ve been sick, self-employed or otherwise shut out of insurance plans that most Americans get in the workplace. But the path is clouded for millions more: the people on the bottom rungs of the economic ladder who are expected to be reached by a major expansion of Medicaid.  (AP Photo/Alex Brandon, File)

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