I have long advocated for ensuring that all Americans have access to health care. That is why I have strongly supported the Affordable Care Act (ACA). On June 28, 2012, the United States Supreme Court upheld the constitutionality of the ACA by a 5-4 vote. The ACA set forth measures that will provide access to affordable, quality health care for Americans, and protect consumers from abusive insurance company practices. Millions have already benefitted from the ACA, including 105 million who no longer have a lifetime limit on their coverage; 54 million who have received free preventive services; 17 million children with pre-existing conditions who can no longer be denied coverage; 6.6 million young adults who have obtained coverage through their parents' plan; and 5.3 million seniors in the 'donut hole' who have saved $3.7 billion on their prescription drugs. Millions more will continue to benefit from this law, which will be fully phased in by 2014. Please find below information regarding the benefits of the ACA, the individual mandate, and the Medicaid expansion. For further information and resources, please visit the ACA's official website at www.healthcare.gov.

Below are some of the numerous benefits provided by the ACA:

- Creates Affordable Insurance Exchanges: Insurance Exchanges are marketplaces where consumers can choose a private health insurance plan that fits their health needs. Each state is responsible for having their Exchanges ready by 2014. They will offer to the public the same kinds of insurance choices Members of Congress have;

- Provides Free Preventive Care: Insurance companies are now required to cover a number of recommended preventive services, such as cancer, diabetes and blood pressure screenings, without additional cost sharing such as copayments or deductibles;

- Provides Coverage for Young Adults: Young adults who cannot get coverage through their employer can stay on their parents' plans until age 26;

- Closes the Medicare Prescription Donut Hole: The "donut hole" in senior prescription coverage (coverage currently ends at $2700 and then restarts only after a patient has spent $6700) will close gradually over the next few years;

- Ends Pre-Existing Condition Discrimination: Insurance companies can no longer deny coverage to anyone because of a pre-existing condition;

- Ends Lifetime Limits on Care: Insurance companies can no longer impose lifetime dollar limits on essential health benefits;

- Ends Coverage Cancellations: Insurance companies can no longer drop your coverage when you get sick due to a mistake you made on your application;

- Ensures the Value of Your Premium Dollar: Insurance companies must spend at least 80 percent of your premium dollars on medical care and quality improvements rather than advertising, overhead, and bonuses for executives, otherwise they will have to provide customers with a rebate;

- Stops Unreasonable Rate Increases: Insurance companies are required to publicly notify and justify raising premiums;

- Provides Tax Credits to Small Businesses: Small businesses can now receive tax credits to provide health insurance to their employees; and

- Fights Fraud: The health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology.

Individual Mandate

The individual mandate will ensure that all Americans have access to health care coverage.

Individuals who already have health insurance through their employers or are self-insured will keep their insurance. There is absolutely no provision within the ACA taking away existing coverage from individuals and families. The law will just make existing plans more secure and affordable.

Americans who currently do not have health insurance will be given the opportunity to buy affordable health insurance through State Exchanges starting in 2014. Exchanges will select health plans qualified to offer coverage; facilitate consumer assistance, shopping, and enrollment; and coordinate eligibility for the Exchange and potential premium assistance. Members of Congress will participate in the same Exchanges as the rest of the country.

Individuals and families, as well as small businesses, who cannot afford to buy health insurance will get a credit to help pay for it. In addition, 17 million more people will qualify for Medicaid in 2014.

The tax penalty only applies to individuals who can afford health insurance and choose not to. On average, an American family pays id="mce_marker"000 more each year for health insurance because of cost shifting from medical services provided to uninsured individuals. If you can afford insurance and choose to not do so, taxpayers will no longer subsidize your care.

The Supreme Court found the individual mandate provision in the ACA to be constitutional under the Tax Clause. The Tax Clause (Article I, Section 8, Clause 1) states that "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States."

Congress already uses the Tax Clause to incentivize people to do things, such as buying a house or saving energy. As the Supreme Court stated: "the mandate is not a legal command to buy insurance. Rather, it makes going without insurance just another thing the Government taxes, like buying gasoline or earning income."

Here is how the individual mandate works as a tax:

• The payment is made when you file your tax return.

• The amount of the payment is "determined by such familiar factors as taxable income, number of dependents, and joint filing status."

• The payment is provided for in the Internal Revenue Code and enforced by the Internal Revenue Service (IRS).

• The amount due will be less than the cost of insurance.

Furthermore, under the Court's ruling, having health insurance is and will continue to be a choice.

Medicaid Expansion

The ACA set forth an expansion of the Medicaid program, which will ensure that individuals and families who cannot afford health insurance be covered under Medicaid. The program is expected to cover 17 million more people. Medicaid will grow to include those with incomes below 133 percent of the poverty line. The Federal government will pay for the Medicaid expansion for the first three years, then for at least 90 percent of the cost until at least 2020.

The Medicaid expansion was also ruled constitutional. However, the Federal government will not be allowed to withdraw Medicaid funding if some states refuse to expand the program. Therefore, expanding Medicaid is now at the discretion of each state nationwide. Because states will not be penalized for not expanding Medicaid, some states will likely opt out.

I was disappointed to see that Florida Governor Rick Scott has already announced that he will not expand Medicaid in Florida. This expansion would cover almost a million Floridians.