WASHINGTON (AP/CBS) - The Supreme Court has upheld the heart of President Barack Obama's health care overhaul -- ruling in favor of the requirement that most Americans can be required to have health insurance, or else pay a penalty.
The decision means the historic overhaul will continue to take effect over the next several years, affecting the way countless Americans receive and pay for their personal medical care.
The court found problems with the law's expansion of Medicaid. But even there, it said the expansion could proceed as long as the federal government does not threaten to withhold the entire Medicaid allotment to states if they don't take part in the extension.
The court found fault with one major provision of the law, which would have expanded Medicaid coverage. Currently, Medicaid is a joint federal-state program that provides health care to certain poor Americans, such as children and the elderly. In 2014, the Affordable Care Act would have opened up Medicaid to anyone with an income under 138 percent of the federal poverty line.
The high court's move hardly ends the political controversy surrounding the law; if anything, the decision to uphold most of the law is sure to renew calls for lawmakers to repeal the Affordable Care Act legislatively.
In response the decision, Republican presidential candidate Mitt Romney said Thursday that while the court found the law constitutional, "What they did not do is say that Obamacare is good law. Obamacare was bad law yesterday, it's bad law today."
The Republican candidate added, "What the court did not do in its last day in session, I will do on my first day" if elected president. He asked voters to join him to "defeat the liberal agenda that makes government too big."
President Obama Thursday said the court's decision reaffirmed the principle that "here in America, in the wealthiest nation on Earth, no illness or accident should lead to a family's financial ruin."
He ran through the law's benefits, such as the provision barring insurers from discriminating against Americans with pre-existing conditions. Several of those provisions will go into effect years from now, after the states have set up their health care "exchanges" or state marketplaces for health insurance.
"When we look back five years from now, 10 years from now... we'll be better off because we had the courage to pass this law," Mr. Obama said.
The president acknowledged that the individual mandate remains a divisive issue, but he pointed out, "This idea has enjoyed support from both parties, including the current Republican nominee for president."
He added, "It should be pretty clear by now didn't do this because it was good politics...I did it because I believed it was good for the American people."
House Majority Leader Eric Cantor in a statement called the court's decision a "crushing blow" to patients and promised that the House would once again vote to repeal the law. "During the week of July 9th, the House will once again repeal ObamaCare, clearing the way for patient-centered reforms that lower costs and increase choice," he said.
In a written statement, Senate Republican leader Mitch McConnell said, "Today's decision makes one thing clear: Congress must act to repeal this misguided law. Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire."
Senate Majority Leader Harry Reid said on the Senate floor, "Our Supreme Court has spoken. The matter is settled. It's time for Republicans to stop fighting yesterday's battles."
The ruling inspired emotional responses from both liberals and conservatives across the country, illustrating how politically explosive the issue is.
Upon learning the news, House Democratic Leader Nancy Pelosi first left messages for the president and the vice president, according to a top Pelosi aide. Then she called Vicki Kennedy, the wife of the late senator and health care reform champion Ted Kennedy. "Now, Teddy can rest," Pelosi told Kennedy.
The Democratic leader -- wearing her lucky purple pumps -- called her husband after that and then celebrated with her staff.
On the steps of the Supreme Court, before it was clear what the ruling was, Tea Partiers and other opponents of the law cheered and waved signs, initially thinking the law was struck down. The cheered, "Constitution wins!" A few minutes later, after the news was cleared up, they started chanting, "this is not over," and "repeal it now."
Supporters of the health care law, meanwhile, danced in front of the court and shouted, "Yes we can! Yes we can!"
Meka Sales, a public health professional from Charlotte, N.C., told CBS News that at a meeting of the American Public Health Association there, people were crying tears of happiness when they heard the news.
"We were totally unprepared for such a favorable decision. I think tears were on deck for a disappointment but what an incredible surprise," she said. "The room was filled with complete joy and a sense of justice for those that will have access to health care in the future. "
The court's four liberal justices, Stephen Bryer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.
The dissenters were Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas.
In a joint statement, they said, "The act before us here exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding."
Kennedy, speaking in court, summarized the dissent by saying, "In our view, the act before us is invalid in its entirety."
Polling has suggested that most Americans oppose the law.
The ruling is also expected to be a boom to most of the health care industry by making coverage affordable for millions of uninsured Americans. But not every company will benefit.
Drugmakers, biotech companies, hospitals and insurers likely will get additional customers because the law requires nearly everyone to have health insurance or pay a fine. That's expected to bring coverage to about 30 million more Americans.
Medical device makers, meanwhile, will be hit with a sizable tax on their sales imposed under the overhaul law, without expectations of boosting sales sharply.
On the news, hospital stocks rising and shares falling sharply for insurers and but only slightly for drugmakers and device makers.
Statments regarding the Affordable Care Act:
"Today's ruling makes it clear that it's up to Congress to replace
the president's health care law with common sense reforms that our nation and
its citizens can afford," U.S.
Senator Bob Corker, R-Tenn said.
"Most American lawyers aren't surprised
by today's Supreme Court decision, nor am I. It turns out that Obamacare,
Romneycare and Robertscare are the same thing – and constitutional," said U.S. Rep. Jim Cooper.
"I am
disappointed in the Court's ruling today," said Sen. Mae Beavers, Chairman of
Senate Judiciary Committee and sponsor of the Tennessee Health Freedom Act which became law in 2011. "I still
believe that punishing a Tennessean for failing to purchase a particular
product that the federal government believes they must purchase simply for
being a citizen is an action that would make our forefathers turn over in their
graves. Thankfully, the Court seemed to agree with me and Rep. Elam and
Rep. Pody on the Commerce Clause issue, which should prove helpful in future
policy debates, even if they found the health care act constitutional on tax
grounds."
"This is exactly what the American people have said they do not want –
Washington bureaucrats between them and their doctors. Under Obamacare, a
panel of unelected bureaucrats now has the unprecedented authority to make
decisions on seniors' healthcare. Additionally, Obamacare cut over $500
billion from the Medicare program, not to mention up to 20 million Americans
could lose their employer-based coverage. It will force American citizens
to endure diminished quality of care, increased insurance costs, and excessive
taxation brought on by inefficient Washington bureaucracy. This is essentially
a tax on human freedoms," said Congressman Stephen Fincher.
(Copyright 2012 by The Associated Press/CBS News Interactive. All Rights Reserved.)
Photo Credit: CBS News
