In a 5-4 decision, the Supreme Court upheld the Patient Protection and Affordable Care Act (PPACA) on June 28.

The 2010 law will have many effects but some of them can be easily summarized. It enters into effect in phases and some of its aspects are already at work.

Right now, because of the act, children up to the age of 26 may remain covered under their parents’ insurance plans. Children with pre-existing conditions also cannot be denied coverage. Plans that have not been grandfathered will cover preventive services without cost sharing.

As of Oct. 1, employers will be required to give summaries of their plans to employees at the time of renewal. Next year, pre-tax dollars contributed to a flexible spending account will be limited to $2,500.

In 2014, the individual mandate, the crux of the law, will kick in. Everyone will be required to carry health insurance or pay a penalty. Also, employers with more than 50 employees will be required to provide insurance or pay a penalty. Finally, insurance will be available for purchase through exchanges designed to promote competition and a wider variety of choices for customers.

The law provides for subsidies for people of certain income levels in order to afford insurance.

The PPACA was upheld in its entirety with one notable exception. The law as written required states to expand Medicaid in order to cover roughly 17 million more people or have all Medicaid funding withheld. However, the Court struck this provision down. Instead, the federal government may withhold new funding from states that refuse to expand Medicaid.