In a 5-4 vote on Thursday, June 28, 2012, the Supreme Court upheld the 2010 Patient Protection and Affordable Care Act (PPACA).

By joining the four liberal justices on the court, Chief Justice John G. Roberts Jr., provided the key vote that upheld the individual mandate, the key piece of the PPACA, requiring Americans to purchase health insurance. The mandate was deemed constitutional under Congress’ power to lay and collect taxes.

The Republican-appointed justices in dissent included, Anthony Kennedy, Antonin Scalia, Clarence Thomas, and Samuel Alito. The four Democratic appointees who voted in support of the mandate were, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan.

So, what does this mean for consumers? In 2014, those without health insurance will be required to purchase it or pay a tax penalty. According to an article in Politico, “In Massachusetts, where a state mandate exists, only about 1% of taxpayers paid a penalty in 2009.”

Many people will qualify for subsidies to aid them in purchasing insurance through health insurance exchanges or qualify for Medicaid funding. Adult children up to the age of 26 can stay on their parents’ health plans, and insurance provided by employers will likely remain the same.

However, the ruling has left many of the poorest Americans at risk of remaining uninsured. The states can opt out of the Medicaid expansion program because the court also ruled that the federal government can’t penalize them by withholding all Medicaid funding. Instead, these states wouldn't get the additional Medicaid money to cover newly eligible enrollees.

And, that could mean trouble for many poor adults who are not eligible for Medicaid under the current system but would have qualified under the expansion. People below the poverty line aren’t eligible for the subsidies. So, in the states that opt not to expand Medicaid, millions of poor adults will likely be left without health insurance.

Addressing the Supreme Court’s decision, President Obama stated that it was a “victory for people all over this country.” However, Republican presidential candidate Mitt Romney stated he would overturn the PPACA if elected in November. “What the court did not do on its last day, I will do on my first day as President of the United States,” said Romney. “That is, I will act to repeal Obamacare.”

Which side of healthcare reform do you fall on?

Additional Resources:

Read the full ruling

SCOTUSblog

The Supreme Court Decision on the 2010 Health Care Law [The New York Times]

What does the Supreme Court's health-care ruling mean for me?[The Washington Post]

President Obama Speaks on Health Reform [Whitehouse.gov]

Supreme Court Ruling on Health Care [Healthcare.gov]