The Washington Post reports on the possible effects of the Supreme Court challenge on the constitutionality of the Patient Protection and Affordable Care Act (PPACA), noting that some facets of health care reform being challenged were being accepted into health care practice before the passage of the PPACA in 2010. Examples include "increasing the role of primary care, especially for low-income patients; forcing hospitals and doctors to work together closely; and reducing pay to hospitals if they don’t meet patients’ expectations or outcome benchmarks set by the government," according to the article.