After two years, the Affordable Care Act has yet to dramatically alter the health-care landscape in Pennsylvania and New Jersey, but the controversial law, facing a U.S. Supreme Court challenge this week, has expanded insurance coverage in small ways and added momentum to changes already under way in the health-care system. "It has made a difference," said David Simon, executive vice president at Jefferson Health System. "It's been a catalyst for people to start thinking about things, looking at new ways of doing business, accelerating the pace of change in terms of increasing quality and efficiency." So far, the regional scorecard looks like this: 133,614 young adults up to age 26 in New Jersey and Pennsylvania have gained health coverage under their parents' plans. 7.9 million residents of the two states no longer have lifetime limits on their health plans. 4.3 million people with private insurance have received preventive services with no out-of-pocket ...