Almost above all else, businesses like certainty. When there’s uncertainty around decisions that can have a significant impact on strategy and bottom line, businesses understandably get nervous. Whether they’re big or small. The ruling by the U.S. Supreme Court on the federal Patient Protection and Affordable Care Act (ACA) afforded a measure of certainty – and probably no small amount of relief — for many businesses wondering how to plan and invest for changing healthcare policy. No one wants to sink time, money and energy into something and then see the ground shift from under them.

The Bay Area Council and our more than 250 member companies recognize that the ACA was an important and historic step in addressing the nation’s need for comprehensive reform to a costly and impenetrably complex system. There are some provisions that our members think make good business sense. There are others that they think don’t. Where we and our members do agree, however, is on the impact that rising healthcare costs have had on businesses over the past decade or more. And the little value that we actually get from the system for what we’re paying.

We spend $2.5 trillion nationally on healthcare and $250 billion in California alone. And except for a recent slowdown because of the recession, health care costs have experienced double-digit increases over the past decade and more. That’s unsustainable. And represents a huge diversion of resources that businesses could be using to invest in other more productive activities – like growing jobs. The high costs we pay also put us at a distinct disadvantage against global competitors that pay a fraction of what we do. On top of that, we’re not getting much healthier.

Working within the framework of the ACA, the Bay Area Council over the past two years has made among our top healthcare priorities controlling costs, promoting market-based solutions, and improving access and quality of care. Our members include some of the largest employers in the Bay Area and the state, including Kaiser Permanente, Wells Fargo, Blue Shield, Dignity Health, Google and Bank of America. Businesses that not only have a huge stake as healthcare providers but also as healthcare consumers.

We have been on the frontlines in the development of the California Health Benefit Exchange, a tool authorized by ACA that the Council believes can be instrumental in driving higher quality care and controlling costs through value-based purchasing and rewarding efficient and coordinated care. It also expands coverage to businesses and consumers that currently can’t afford health insurance. And we’re working on many other fronts to educate and inform policy makers and the business community about the imperative for keeping our economic health at the forefront of the discussion.

While this week’s Supreme Court decision provides some level of certainty on ACA, it is not an end point. Indeed, the ACA is now likely to become a primary issue in the Presidential race, with Republican candidate Mitt Romney renewing his call to overturn it. We suspect that the political and ideological rhetoric over the ACA, the Supreme Court ruling and healthcare will dominate the debate. We can’t predict the outcome in November, but what we do know for certain is that California must keep its eye focused on controlling costs, improving access and healthcare quality and making the healthcare system more transparent and easier for businesses and consumers to understand and use.

Jim Wunderman is President and CEO of the Bay Area Council, a non-partisan, business-sponsored public policy and advocacy organization founded in 1945.