That perception can just as easily be applied to health insurance exchanges (HIXs). Although blueprints for standing up an HIX are due on Nov. 16, a Kaiser Family Foundation study determined that as of September’s end a mere 19 states were actively working to either build their own exchange or partner with the government to create one.

Here’s why all this matters: Digitizing the health system and enabling exchange of patient and population information, pulling more Americans into the insurance pool, making insurance more transparent – as well as other ACA provisions I didn't mention, such as shared savings via the accountable care model – are all foundational pieces to reforming the healthcare payment system and ultimately achieving the triple aim of improving patient care at a lower cost that bolsters population health. 

And a significant chunk of that work must be accomplished in the next four years – against what is still, despite President Obama winning a second term, tremendous opposition at the federal and state level – to ensure that the next president cannot uproot the ACA via “repeal and replace.”

So, yes, today we know the law has been preserved. But we’d best let that champagne cork alone until we see how ACA is greeted by all the requisite players during Obama’s second term, amid economic, jobs, energy and military priorities.

Because if even approximately half of America’s states manage to stay on track with ACA provisions, and the others continue their resistance there will be profound healthcare digital divide scarring the ACA’s other successes.