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Friday, June 29, 2012 – Daily News WASHINGTON (AP) — The Supreme Court on Thurs- day upheld virtually all of President Barack Obama's his- toric health care overhaul, including the hotly debated core requirement that nearly every American have health insur- ance. effect, could proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care. The ruling hands Obama a campaign-season victory in rejecting arguments that Congress went too far in approving the plan. However, Republicans quickly indicated they will try to use the decision to rally their supporters against what they call ''Obamacare,'' arguing that the ruling characterized the penalty against people who refuse to get insurance as a tax. The 5-4 decision meant the huge overhaul, still taking sion was a victory for people all over this country.'' GOP presidential candidate Mitt Romney renewed his criticism of the overhaul, calling it ''bad law'' and promising to work to repeal it if elected in November. Breaking with the court's other conservative justices, Chief Justice John Roberts announced the judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans. Roberts explained at length the court's view of the mandate as a valid exercise of Congress' authority to ''lay and collect taxes.'' The adminis- tration estimates that roughly 4 million people will pay the penalty rather than buy insurance. Even though Congress called it a penalty, not a tax, Roberts said, ''The payment is collected solely by the IRS through the normal means of taxation.'' Roberts also made plain the court's rejection of the administration's claim that Congress had the power under the Constitution's commerce clause to put the mandate in place. The power to regulate interstate commerce power, he said, ''does not authorize the mandate. '' Stocks of hospital companies rose after the decision was announced, while shares of insurers fell sharply. Shares of drugmakers and device makers fell slightly. The justices rejected two of the administration's three Obama declared, ''Whatever the politics, today's deci- High court upholds Obama health law by 5-4 vote 5B More than eight in 10 Americans already have health insurance. But for most of the 50 million who are uninsured, the ruling offers the promise of guaranteed coverage at affordable prices. Lower-income and many middle-class families will be eligible for subsidies to help pay premiums starting in 2014. There's also an added safety net for all Americans, insured and uninsured. Starting in 2014, insurance compa- nies will not be able to deny coverage for medical treatment, nor can they charge more to people with health problems. Those protections, now standard in most big employer plans, will be available to all, including people who get laid off, or leave a corporate job to launch their own small business. Seniors also benefit from the law through better Medicare coverage for those with high prescription costs, and no copayments for preventive care. But hospitals, nursing homes, and many other service providers may struggle once the Medicare cuts used to finance the law really start to bite. Illegal immigrants are not entitled to the new insurance coverage under the law, and will remain one of the biggest groups uninsured. Obama's law is by no means the last word on health care. Experts expect costs to keep rising, meaning that lawmakers will have to revisit the issue perhaps as early as next year, when federal budget woes will force them to confront painful options for Medicare and Medicaid, the giant feder- al programs that cover seniors, the disabled, and low-income people. monumental struggle in which all Republicans voted against it. House Majority Leader Eric Cantor, R-Va., said Thursday the House will vote the week of July 9 on whether to repeal the law, though such efforts have virtually no chance in the Democratic-controlled Senate. House Speaker John Boehner, R-Ohio, said the health arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. ''Because the Constitution permits such a tax, it is not our role to for- bid it, or to pass upon its wisdom or fairness,'' Roberts said. The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to with- hold states' entire Medicaid allotment if they don't take part in the law's extension. The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome. Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented. Kennedy summarized the dissent in court. ''In our view, the act before us is invalid in its entirety,'' he said. The dissenters said in a joint statement that the law ''exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding.'' In all, the justices spelled out their views in six opinions totaling 187 pages. Roberts, Kennedy and Ginsburg spent 51 minutes summarizing their views in the packed courtroom. The legislation passed Congress in early 2010 after a from Washington to state capitals. Only 14 states, plus Washington, D.C., have adopted plans to set up the new health insurance markets called for under the law. Called exchanges, the new markets are supposed to be up and run- ning on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers. Most Republican-led states, including large ones such as The health care overhaul focus will now quickly shift care law makes it harder for small businesses to hire work- ers. ''Today's ruling underscores the urgency of repealing this harmful law in its entirety,'' he said. But Senate Majority Leader Harry Reid, D-Nev., heaped praise on the court's decision, and the 2010 law, in a Senate speech. ''Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to afford- able, quality health care for every American, regardless of where they live or how much money they make,'' he said. After the ruling, Republican campaign strategists said Romney will use it to continue campaigning against ''Oba- macare'' and attacking the president's signature health care program as a tax increase. ''Obama might have his law, but the GOP has a cause,'' Texas and Florida, have been counting on the law to be over- turned and have failed to do the considerable spade work needed to set up exchanges. There's a real question about whether they can meet the deadline, and if they don't, Wash- ington will step in and run their exchanges for them. In contrast to the states, health insurance companies, major employers, and big hospital systems are among the best prepared. Many of the changes called for in the law were already being demanded by employers trying to get better value for their private health insurance dollars. ''The main driver here is financial,'' said Dr. Toby Cos- said veteran campaign adviser Terry Holt. ''This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history.'' Democrats said Romney, who backed an individual health insurance mandate when he was Massachusetts gov- ernor, will have a hard time exploiting the ruling. ''Mitt Romney is the intellectual godfather of Oba- macare,'' said Democratic consultant Jim Manley. ''The bigger issue is the rising cost of health care, and this bill is designed to deal with it.'' grove, CEO of the Cleveland Clinic, which has pioneered some of the changes. ''The factors driving health care reform are not new, and they are not going to go away.'' The Medicaid expansion would cover an estimated 17 million people who earn too much to qualify for assistance but not enough to afford insurance. The federal and state governments share the cost, and Washington regularly imposes conditions on the states in exchange for money. Roberts said Congress' ability to impose those conditions has its limits. ''In this case, the financial 'inducement' Con- gress has chosen is much more than 'relatively mild encour- agement' — it is a gun to the head,'' he said. The law says the Health and Human Services Depart- ment can withhold a state's entire Medicaid allotment if the state doesn't comply with the health care law's Medicaid provisions.