By now, most Americans know that the Supreme Court upheld the bulk of President Barack Obama’s health-care reform law. But many are left wondering, what’s next?

Regardless of the ruling, everyone knows that we haven’t begun to deal with many of our health-care challenges and that the reform law won’t get the job done. We haven’t addressed the imperative of prudently reforming the Medicare and Medicaid entitlements. We haven’t figured out how to extend access to quality care for every American. And we haven’t come to terms with how we’re going to handle the coming wave of 77 million baby-boomers at or nearing retirement age.

We do know that the law is not living up to the promises made by the president and supporters of the legislation. Health-care costs are rising, not falling, for the federal government, employers and families.

A new Senate report projects that the law will cost $2.6 trillion by 2023 — a massive increase over the $900 billion the president initially promised. Private employer health-care costs also continue to rise, some of which will be passed on to employees. Some employers will have no choice but to stop offering coverage altogether.

Costs are rising for Americans, too. The average family has seen a sharp spike in premiums due in large part to health reform. The law also broke the fundamental promise that Americans can keep their health-care coverage if they like it. According to the Congressional Budget Office, in 2016, 4 million Americans will lose their employer-based health insurance.

Bottom line: The law fails to implement sensible solutions to control costs, improve quality, and increase coverage. We can’t afford to settle for “reform” that doesn’t accomplish those fundamental goals.

Achieving meaningful health reform will be hard — but not impossible. We can drive down costs by implementing private-sector solutions that improve competition.

Consumers should be allowed to choose the coverage they want, and providers should be paid based on the quality of care — not merely the quantity of services rendered. Medical liability reform that curbs the need for providers to practice defensive medicine would also drive down costs. And widespread adoption of health information technology — including electronic prescriptions and medical records — could further improve quality, lower costs and reduce medical errors.

Far from putting an end to the debate, the Supreme Court ruling has only reaffirmed our commitment to get health reform right. The U.S. Chamber of Commerce will work as hard as ever toward a comprehensive solution that improves quality, expands coverage, and reduces costs.

— Tom Donohue is president and CEO of the U.S. Chamber of Commerce.