It's a long-term "solution" to a problem that doesn't directly resolve the core issues, and in the short-term will only add to the costs, bureaucracy, and overall complexity of our healthcare system.
On the one hand, some of the more hyped positive reforms, like eliminating discrimination based on pre-existing conditions, allowing families to keep kids on until 26, and giving more aid to the elderly with prescription drugs are beneficial to people in those situations and that's a good change all things considered.
But the mandate in itself doesn't really help address cost, particularly when the Supreme Court's ruling on the Medicaid expansion is considered. The mandate when coupled with the expansion was geared towards getting more people into the collective healthcare market; the mandate as a means towards those who can afford insurance and choose not to purchase it...the expansion as a means towards the poor and working poor who can't afford it and may want to purchase insurance.
Giving states the option to opt out of the expansion means that the intended addition of subsidized individuals and families into the market isn't a given, and so the 17 millionish who were expected to be added isn't a given now, because there were 26 states that sued regarding the expansion and it can be assumed that because they now have the right to turn down that option, they most likely will. (I know that as more people in their states gain more knowledge on the ACA bill, there would be more pressure on state governments to accept the expansion, but it isn't a lock.)
With the mandate, the penalty would more adversely affect those with less means more than those with more. If I'm an a single individual making 33K a year, and am not eligible for the exemption, then you pretty much have to bite the bullet and purchase insurance as opposed to a single individual making 80K a year who might be in a better position to just eat the penalty, and continue not purchasing insurance.
Those on welfare are already (for the most part) eligible for medicaid, and even if they were not, would most likely qualify for the exemption, so they would benefit from the new law.
The biggest issue with the law is that healthcare providers and pharmaceutical companies stand the most to gain, and have limited checks in the system. The day after the ruling, stocks in these companies went up, because they know they stand to make MORE money. Even if the administration's estimates of people added falls way below the mark, it's pretty much a given that millions of people are gonna sign up for insurance now.
The market-based emphasis means that although insurance companies can't just jack up rates, or deny for conditions that they previously did, businesses (which is where most people get their insurance) can make changes that will benefit them at the potential cost of their workers plan choices. For example, if a company previously offered healthcare through United Healthcare, if they can find a provider that is cheaper they can change the provider they offer insurance from regardless of the fact that their employees may have no problems with the current provider. The inclusion in the ACA that dictates that all insurance providers have to offer preventative services means that finding a provider that is cheapest may trump finding a provider that offers the most value. Plus, the fact that insurance providers have to offer rebates to people for their associated healthcare costs that exceed 80% of what they pay, means that insurance companies will find ways to get the most out of of the least to make sure they maximize profit while staying in line with what they are regulated to monetarily be accountable for.
In the end, it's just a big win for insurance and drug companies. It's a shame that the power and influence that they have trumps the value that a true consumer-focused approach like a single payer system would provide.
so what? 
