What's Your Reaction to Supreme Court's Obamacare Ruling?

The individual health insurance mandate is constitutional, the U.S. Supreme Court ruled Thursday in a 5-4 decision, upholding the central provision of President Barack Obama's signature Affordable Care Act.

The controlling opinion, written by Chief Justice John Roberts, upheld the mandate as a tax. It found that the U.S. government may use its tax powers to push Americans to buy medical insurance, although it limits the Medicaid provision, the New York Times reports. Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan joined Roberts in the majority.

Roberts wrote that the mandate provision "need not be read to do more than impose a tax. That is sufficient to sustain it."

California will be impacted more than any other state simply because it's the most populous, but also because it has the highest number of uninsured residents, according to the California Endowment. The private, nonpartisan statewide health foundation, established to improve public health and increase health care access for Californians, is non-partisan. The Endowment has invested in "a multi-million-dollar statewide education effort" to help people get enrolled.

Not only are Calfornians "less likely to be insured, receive employer-based coverage, or be able to afford coverage," an Endowment ACA background paper stated, "Californians are also at greater risk of being denied for pre-existing conditions than the rest of the nation."

For the Supreme Court decision on the constitutionality of what's been dubbed Obamacare, the formally titled Patient Protection and Affordable Care Act, these are the key points that were under consideration:

The Individual Mandate

Should Americans be required to buy health insurance? Viewed by many to be the linchpin of the entire act, it requires most Americans to enroll in a health insurance plan or be financially penalized. Polls say that most Americans oppose this part. Its opponents have argued that Americans should haven't to buy something they don't want and might not need. The Obama administration says that all Americans will likely need medical care at over the course of their lives and that the uninsured who are now getting free health care increase costs for the rest who pay. 

Shared Cost of Medicaid

Should states have to carry a greater share of the cost of Medicaid or face losing federal money? Some states argued that the federal government is overreaching by imposing these kind of conditions being placed on federal funding. The federal government has said that it is within its rights to oversee how this money is spent.

The Timing of the Challenge

Is is too early for the Affordable Care Act to be in front of the court, given that the individual mandate isn't even set to go into effect for another year and a half? Under the Anti-Injunction Act, citizens are barred from challenging the legality of a tax until they've actually paid it. But there's been disagreement on whether that rule applies and whether a penalty under the act is actually a tax.

Health Reform, Minus the Mandate

If the court struck down the individuate mandate, can the rest of the law be constitutional? Both sides have said that the mandate is essential for the act to operate. But some saw room for separate rulings on guaranteed converage for all those who apply for insurance—even those with pre-existing conditions—and whether insurance plans would have to offer coverage at similar prices to all of their customers, regardless of risk factors.  

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