Chief Justice John Roberts proved himself an independent thinker last month, siding against his fellow conservatives (and Republican appointees) in upholding the Affordable Care Act of 2010. Roberts agreed that Congress could not force a citizen to buy insurance, but allowed the individual mandate to survive as a tax. In the meantime, the ruling placed limits on federal power to expand Medicaid, leaving 16 million people in the lurch. Liz Borkowski says “the Supreme Court’s decision clouds what should have been a clear distribution of the most beneficial impacts to the most needy.” Kim Krisberg heard the news at a meeting of the American Public Health Association, where Georges Benjamin said it “marks tremendous progress towards reshaping our health system into one that saves the lives of at least 44,000 people who die annually simply because they do not have health insurance.” On Denialism Blog, Mark Hoofnagle compares insurance systems around the world, and looks forward to more economical healthcare. He writes, “We can do it expensively, wastefully, and emergently in the ER, or we can do it like thoughtful, decent citizens who care about each other’s welfare.”