Today's guest blog was written by Brett Johnson, an associate director for medical and regulatory policy at the California Medical Association (CMA). Johnson primarily works on policy issues regarding the commercial health insurance market and health care reform, specifically the California Health Benefit Exchange. He also is responsible for CMA's health reform newsletter, Reform Essentials.

In the wake of the decision by the United State Supreme Court to uphold the majority of the Patient Protection and Affordable Care Act (ACA), Californians are beginning to take stock of what the ruling means for the Golden State.

Once examined, however, the ruling may prove to be a bit underwhelming.

While attempting not to undervalue the court's historic 5-4 ruling, the fact of the matter is that operations here in California will be changed very little by the decision, if at all.

When gauging the decision's impact, it's important to remember that California was the first state following the signing of the ACA to establish its Health Benefit Exchange, and since then has been working aggressively to ensure that the new marketplace would be up and running by 2014.

In recent weeks, several health care observers across the nation have noted that California looks to be one of the states most-ready to handle full implementation of the ACA.

Even as the court's decision loomed, officials such as Diana Dooley, the state's secretary of health and human services, and Peter Lee, executive director of California's exchange board, noted that the state's exchange would continue making progress regardless of the case's outcome.

If anything, the court's ruling last week only serves to remove some skepticism and uncertainty regarding the law and California's ongoing preparations.

No longer will ACA-related legislation working its way through the state Capitol have to be qualified with constitutional questions of "what if" from opponents of reform.

Perhaps more importantly, the ruling also confirms that the $45 billion to $55 billion that California is slated to receive from the federal government in order to fund the Medicaid expansion called for under the ACA is no longer in jeopardy.

With those funds, California is expected to cover an additional 1.2 million to 1.6 million residents, according to recent estimates.

While the ruling will almost certainly be remembered as one of the most significant Supreme Court decisions in recent memory, in California, it continues to be business as usual.

For more information regarding California's ongoing implementation of the Patient Protection and Affordable Care Act, please see the latest issue of the California Medical Association's Reform Essentials newsletter.