HEALTH BULLETIN .CO: BREAKING NEWS: Supreme Court UPHOLDS individual mandate in Obama's health care reforms

Court decides that it is not legal to force Americans to buy insurance as part of the controversial individual mandate

Court says it is legal to penalize them if they do not have insurance

Ruling rejects the mandatory Medicaid expansion the law required

It means that those who fail to buy health insurance will pay a tax fine and employers will also be fined if they fail to contribute to the insurance coverage of their workers

The Supreme Court today upheld President Barack Obama's signature healthcare law in an historic ruling - but the Chief Justice dealt a blow to the White House by declaring that fining people for not buying insurance is a tax.

In a dramatic 5-to-4 ruling that represents a major victory for Obama and a potential boost to his re-election chances, the top U.S. court decided that the ‘individual mandate’ compelling people to get health insurance was constitutional.

The political sting in the tail for Obama, however, could be that the court rejected Obama administration’s argument that the mandate was permissible under the commerce clause and instead ruled that Congress nevertheless ‘has the power to impose’ it under its taxing authority.

It means that those who fail to buy health insurance will pay a tax fine and employers will also be fined if they fail to contribute to the insurance coverage of their workers.

Taking to the streets: Protestors have lined the Mall during the days leading up to Thursday's announcement

When he was selling what became known as ‘Obamacare’, the President insisted that it was in no way a tax. In September 2009, he told ABC News: ‘For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase.

‘What it’s saying is, is that we’re not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase.’

Justice Anthony Kennedy, normally considered the swing vote on the court, sided with the three consistent conservatives Antonin Scalia, Clarence Thomas and Samuel Alito in opposing the decision.

But it was a major surprise that Chief Justice John Roberts, appointed by President George W. Bush, aligned himself with the liberal justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, Elena Kagan.

Celebrating: President Barack Obama is scheduled to speak in a few short hours and he will undoubtedly praise the court for approaching the issue in a relatively non-partisan way

The historic ruling triggered an immediate war of words between the rival parties, with Democrats hailing it a moral victory while Republicans urged voters to overturn the Supreme Court's decision by electing Romney.

House Minority Leader Nancy Pelosi described it as 'victory the American people' but Sarah Palin tweeted: 'He (Obama) said it wasn't a tax. Obama lies; freedom dies.'

Mitt Romney held a press conference to air his reaction to the ruling, saying that 'I agree with the dissent.'

'What the court did not do in its last day in session, I will do in my first day if elected President of the United States,' he said in the Thursday press conference.

Dissenting opinion: Mitt Romney spoke about how he is disappointed by the Supreme Court ruling

'It did not do was say that it is a good law or a good policy... Obamacare was a bad law yesterday, it is a bad law today.'

THE SUPREME COURT'S HISTORIC RULING ON OBAMACARE

WHO DOES IT AFFECT?

The decision affects nearly every American and marks a major milepost in a century of efforts to make health care available to all.

WILL ANYONE NOT BE COVERED BY IT?

An estimated 26 million people will remain without health coverage once the law is fully implemented, including illegal immigrants, people who don't sign up and elect to face the fine instead, and those who can't afford it even with the subsidies.

WHAT NOW?

The 2010 health care law will continue phasing in as planned. It's expected to bring coverage to about 30 million uninsured people, so that more than 9 in 10 eligible Americans will be covered.

Some parts are already in effect: Young adults can stay on their parents' insurance up to age 26. Insurers can't deny coverage to children with health problems. Limits on how much policies will pay out to each person over a lifetime are eliminated. Hundreds of older people already are saving money through improved Medicare prescription benefits. And co-payments for preventive care for all ages have been eliminated.

WHAT'S NEXT?

Starting in 2014, almost everyone will be required to be insured or pay a fine. There are subsidies to help people who can't afford coverage. Most employers will face fines if they don't offer coverage for their workers. Newly created insurance markets will make it easier for individuals and small businesses to buy affordable coverage. And Medicaid will be expanded to cover more low-income people.

Insurers will be prohibited from denying coverage to people with medical problems or charging those people more. They won't be able to charge women more, either. During the transition to 2014, a special program for people with pre-existing health problems helps these people get coverage.

An assortment of tax increases, health industry fees and Medicare cuts will help pay for the changes.

IS THE ISSUE SETTLED NOW?

Not necessarily. Although the court found it constitutional, the health care law still could be changed by Congress. Romney and Republican congressional candidates are campaigning on promises to repeal it if elected in November.

---The Associated Press

In a major point of contention, Mr Romney said that the plan would add trillions to the country's deficit and national debt- but that was rebuked by liberal commentators.

Despite its ruling on individual mandates, the Court rejected the mandatory Medicaid expansion, arguing that it is not legal to threaten to withhold other benefits if the states opted against certain other portions of the Affordable Care Act.

Commentators and legal analysts immediately gave Chief Justice Roberts much of the credit for the passage of the landmark law.

Five of the more conservative justices said that it violates the commerce clause, but that is more or less irrelevant because Chief Justice Roberts determined that it is legal under a different tax avenue.

The legislation was controversial from the get-go, with 26 states challenging its constitutionality before it was picked up by the Supreme Court.

Because the Affordable Care Act is arguably Mr Obama's most significant undertaking since taking office in January 2009, the decision will undoubtedly shape the path of the presidential campaign.

Mr Obama was obviously hoping for a win, and now that it was ruled in his favor, he is expected to make a speech very soon.

Minority leader Nancy Pelosi already spoke out on the decision, Tweeting: 'Victory for the American people! Millions of American families and children will have certainty of health care benefits + affordable care.'

Democratic congressman Jerrold Nadler from New York released a statement about the ruling.

'Today, in upholding the Affordable Care Act, the Supreme Court has shown that, even at a time when Washington seems to have reached a new level of dysfunction, there remains a respect for the rule of law, for precedent, and for the ability of Congress to legislate on matters that affect the American people,' he said in a statement.

The intricacies of the decision reveal that the Supreme Court weighed a number of very subtle legal options in coming up with their decision.

Throughout the debate, the Obama camp- most notably Solicitor General the court made the argument that the solicitor General Donald Verrilli- tried desperately to avoid deeming the Affordable Care Act as a tax.

Today's decision, however, shows that the nine justices found that the only legal way for the individual mandate to be enacted, however, is if it is considered under the taxing authority given to Congress.

Effectively the Court decided that it would violate the interstate commerce clause if the law were to be treated in the way that it was initially argued by Mr Obama's administration. But, that does not mean that it is illegal in its entirety.

Some Democratic analysts, including MSNBC’s Chris Matthews, are painting the Chief Justice’s decision to break from his conservative tendencies and write the unexpected ruling as a result of a moral decision to support the spread of a national health care law.

Proud: Nancy Pelosi celebrated with staff during the moments after the ruling was announced

Watching as it happens: Minority Leader Nancy Pelosi has been a stalwart supporter of the health care policy throughout the debate and she was clearly pleased when the news came in this Thursday morning

'Now Teddy can rest': One of Pelosi's first phone calls was to Senator Ted Kennedy's widow Vicki because he was a champion of universal health care prior to his death