The long-awaited Supreme Court vote on the health care bill Thursday upheld the individual mandate, which requires individuals to buy health insurance or face a fine, as a tax. Whether the Affordable Care Act could have survived if the mandate had been struck down was in question throughout the months-long deliberations and heated oral arguments of the court.
The ruling on the mandate keeps the entire ACA together at the seams. Obama's health care plan would insure millions of Americans, ban insurers from denying coverage based on pre-existing conditions and allow young people to stay on their parent's insurance up to age 26.
According to SCOTUSblog, "the court reinforces that individuals can simply refuse to pay the tax and not comply with the mandate."
The ruling also looked at a planned expansion of Medicaid to 16 million people.
The court ruled that the Medicaid expansion was constitutional, but that the federal government could not withhold federal funds if states didn't comply, said SCOTUSblog.
According to Chris Hayes on Twitter, "Medicaid expansion is the biggest, most immediate source of new coverage for folks."
The decision was made 5 to 4, with Justices Roberts, Sotomayor, Breyer, Ginsburg and Kagan voting in favor.
Reactions to the Supreme Court ruling have
Reactions to the news showed that the debate about the health care law is far from over. Groups like Physicians for a National Health Program (PNHP), which pushes for a single player healthcare system, drove home the point that the health crisis far from over, even with the Affordable Care Act no longer under threat.
"Although the Supreme Court has upheld the Affordable Care Act, the unfortunate reality is that the law, despite its modest benefits, is not a remedy to our health care crisis: (1) it will not achieve universal coverage, as it leaves at least 26 million uninsured, (2) it will not make health care affordable to Americans with insurance, because of high co-pays and gaps in coverage that leave patients vulnerable to financial ruin in the event of serious illness, and (3) it will not control costs," said Steffie Woodhandler and David Himmelstein, co-founders of PNHP and professors at the Harvard Medical School.
Others, like Rep. Dennis Kucinich, were more hopeful.
"Today's ruling demonstrates that health care is not the third rail in American politics. It demonstrates that reform is possible. It demonstrates that Medicare for All is inevitable," said Kucinich in a statement.
"Today is an important day for millions of Americans who will not be denied benefits under the Affordable Care Act. But this is not the end of the conversation. Medicare for All is the solution America needs to stop the ever-rising costs of health care and provide full coverage for everyone. I supported the Affordable Health Care Act as a step in the right direction, but it is only the first step in a long journey.