Health Decisions Reviews

Do courts of appeals decisions only affect their region?
Do precedents and decisions set by each circuit court of appeals only affect their particular region? For example, do Ninth Circuit decisions and precedents, despite the Ninth Circuit being a Federal court, only affect the people living in the West Coast?
Am I getting this right? Could someone explain it? Like if the Ninth Circuit ruled the Obama health care plan (just an example!) unconstitutional, would it theoretically, if never reviewed by the Supreme Court, only mean the health care couldn’t be enacted on the West Coast? Is there another example someone could use to explain this?
So only the Supreme Court’s decisions affect the whole country?
Why not post this in Politics and Government rather than here? You will probably get a better answer as this is quite technical.
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