Thursday, June 28, 2012
Failed IVF attempt tied to depression, anxiety
Women who are anxious before in vitro fertilization (IVF) are no less likely to conceive, according to new research.
However, if the treatment is unsuccessful, it may adversely affect a woman’s mental health.
Two separate studies are published in the journal Fertility and Sterility — one focused on women going through IVF and the other followed women trying to conceive naturally.
“Our findings are consistent with the most recent research,” said Lauri A. Pasch, lead researcher and a clinical psychologist at the University of California, San Francisco Center for Reproductive Health.
“I think we can safely say to women — Stop worrying about being worried,” said Pasch.
A woman should not put pressure on herself to be a “good IVF patient” who’s completely stress-free, Pasch added. And she should not blame herself if she is anxious and the IVF attempt fails.
The second study, from the UK, followed 339 women who were trying to become pregnant naturally.
Overall, 61 percent of these women became pregnant over a period of about six months. And success was not linked to a woman’s mental health once the researchers accounted for factors like age and smoking habits, reported a team led by Courtney Lynch of the Ohio State University College of Medicine in Columbus.
However, women who experience an unsuccessful IVF may see a drop in their mental health, Pasch and her colleagues found.
The study followed 202 women undergoing IVF at five San Francisco practices. Before the procedure, all the women were interviewed with standard questionnaires on depression and anxiety.
Overall, the researchers found that women whose IVF treatment failed were at greater risk of anxiety or depression in the coming months.
Of 103 women with a failed IVF, 60 percent had symptoms of a clinical anxiety disorder – up slightly from 57 percent before their IVF cycles. And 44 percent had clinical depression, which was up from 26 percent before the procedure.
It’s not surprising that many women with a failed IVF attempt would have such symptoms, according to Pasch. But there has actually been little research into how IVF outcomes may affect women’s mental health, she said.
And although women with a failed IVF attempt were at higher risk, even women who became pregnant had considerable rates of depression and anxiety as well, researchers found.
During pregnancy, 30 percent of those women had depression in the “clinical range,” while half had clinical-level anxiety. Those rates were similar to what they were before IVF.
According to Pasch, infertility practices should do more to help women with mental health symptoms – but not as a way to improve their odds of IVF success.
“Psychological interventions need to be geared toward helping women feel better, and not toward increasing their chances of pregnancy,” Pasch said.
Although a few larger university-linked infertility centers have on-site services for women who need mental health counseling, most practices do not, said Pasch.
Women can, however, ask their center for a referral to counseling if they need it. Pasch said women can also seek help from local support groups.
Stillbirth: Surviving Emotionally
Stillbirth is one of the most devastating of losses, affecting over 25,000 families each year. Stillbirth touches families of all races, religion and socio-economic status. For many parents stillbirth is a loss that hits unexpectedly. In fact, up to half of all stillbirths occur in pregnancies that had seemed problem-free.
With any loss, grief can come in many different ways. The initial shock and numbness will eventually fade to other very intense emotions. The grieving process is different for everyone, with the one common thread being pain. Allowing yourself and others to experience this in individual ways can be vital to eventual healing.
What should I do if my baby has died?
As you are trying to cope with the heartbreaking news, you will also have to face an uncomfortable dilemma. If your baby has died before labor begins you will probably be given the choice of what type of birth you would prefer; this is not an easy decision to make. Giving birth naturally may give you a little more time to work through the shock and begin the grieving process. Generally, it is medically safe for the mother to continue carrying her baby until labor begins which is normally about 2 weeks after the baby has died. This lapse in time can have an affect on the baby’s appearance at delivery and it is best to be prepared for this.
Some women prefer to be induced as soon as possible because it is emotionally difficult for some women to think of carrying their deceased baby in the womb. If labor has not started after two weeks, induction would become necessary to avoid dangerous blood clotting. A cesarean is usually only recommended if complications arise during labor and delivery.
How will I recover physically after having a stillbirth?
After you give birth to a stillborn baby, your body needs time to heal as it would in any birthing situation. Your doctor will probably recommend taking it easy, to give your body time to heal. A few days after you get home from the hospital, your breasts may fill with milk. The milk will normally disperse within a few days but your breasts may feel sore and tender for awhile. This experience can be upsetting because it is reminder of your loss. Try taking a warm bath to ease the discomfort. You may continue to bleed off and on for a few weeks. If you continue to bleed beyond three weeks, have a fever, or cramping, it is important to contact your healthcare provider.
Saying hello, goodbye, and making memories:
After the tests are completed, you will usually have the choice to spend time alone with your baby. You can find comfort in looking at, touching, and talking to your baby. Most parents find it helpful to make memories of this precious time that will last a lifetime. Here are a few ways you can make memories with your baby:
You will be able to spend as much time as you need with your baby, but at some point you will need to say goodbye. This will probably be one of the most challenging things to do because it is so final. Allow yourself to cry; expressing emotion is natural in the grieving process. Having the keepsakes will remind you that a part of your baby will always be with you.
What can I expect when I leave the hospital?
You normally will be allowed to leave the hospital when you are physically ready. Leaving the hospital may be filled with a mix of emotions. You may be feeling ready to get to the safety and security of your own home, but at the same time dealing with the anger and sadness of not having a baby to take home with you. Having supportive family around can help you get through this. Some parents have found it helpful to have a family member move all the baby items into a spare room before they get home so that these can be gone through at a time when the parents feel ready.
What about my family members?
With the loss of your baby, your family members will also grieve. Your baby is someone’s granddaughter, brother, cousin, nephew or sister. It is important for your family members to spend time with the baby. This will help them come to terms with their loss. If you have other children, it is very important to be honest with them about what has happened by using simple and honest explanations. It is your decision whether you would like the children to see the baby. Ask for a Child Life Specialist at the hospital; these are trained professionals who can help you prepare your children for the heartbreaking news, and prepare them to see the baby if you wish.
How do I tell people about our loss?
Telling family members and friends can be emotionally draining and overwhelming. You may want to have one family member be “in charge” of telling others about what has happened, about funeral arrangements, and ways they can help.
What should I do about a funeral or memorial service?
A social worker or chaplain at the hospital can help you make funeral arrangements. Most funeral homes will provide a free coffin, burial or cremation for stillborn babies. Although there may be other expenses, this contribution will alleviate some of the financial strain. The date of the service will depend on when the hospital releases your baby. The length of the service as well as the number of family members you want present is entirely up to you. This may be very difficult for you but also comforting to know your baby is at rest.
What should I do with the baby items?
The time will come when you are ready to sort through your baby items deciding what do to do with them. Ask a friend or relative to help you find out what store return policies are and assist you in getting items returned. Put items that you want to keep, together in a special box that you can get into when you need to. Try not to make any hasty decisions such as giving everything to charity; you may regret this later. You may want to give some items to charity, return some back to the store and keep some for the next baby.
How can I help myself grieve?
The following are things you can do to help yourself get through this difficult time in your life.
Healing will take time. Little by little the emptiness that you feel in your heart will lessen and you will learn to live your life again. You will have new dreams and hopes for the future and your outlook on life will change. This means you are beginning to accept your loss, not forget it.
What are my chances of having another stillbirth?
The chances of having another stillbirth are very small. In fact, most women will give birth to a healthy baby after experiencing a stillbirth.
When should we try again?
When to try again is something only you and your partner can decide. You will probably be physically ready before you are emotionally ready to start trying again. Future pregnancies will be tougher for you if you do not come to terms with your loss. Some professionals recommend you wait for at least a few months or up to a year before trying again as to give yourself time to grieve.
Stillbirth risk highest in heaviest and lightest fetuses
Stillbirths are more common among the heaviest and lightest fetuses, according to a new study from Canada.
Researchers found that 19 percent of all stillbirths occurred in fetuses whose weight put them in the lightest 10 percent of all fetuses of their age, with 6 percent of stillbirths occurring in the lightest 1 percent.
Fetuses among the heaviest 1 percent of those their age accounted for another 1 percent of all stillbirths.
“Extreme underweight and overweight states confer the highest risk of stillbirth," the researchers wrote.
Stillbirth
is
commonly defined as death of a fetus after 23 weeks pregnancy and after
the fetus weighs 500 grams (about 1.1 pounds); in this study, the
researchers included fetal deaths that occurred after 20 weeks of
pregnancy. The researchers collected data on all births in Ontario
between 2002 and 2007 — a total of 767,016 live births and 4,697
stillbirths.
Problems with the placenta can result in a fetus being severely underweight, while fetuses are most at risk for being overweight if the mother is obese or has diabetes, according to the researchers.
The researchers say their finding may help doctors assess when it might be appropriate to deliver a baby early, in cases where the chance of it surviving outside the womb might be higher than the chance surviving in the womb.
In the developed world, stillbirths occur
in 6 out of 1,000 births — a rate that is higher than the infant death
rate from conditions such as sudden infant death syndrome or
complications of premature birth, the researchers said.
Researchers found that 19 percent of all stillbirths occurred in fetuses whose weight put them in the lightest 10 percent of all fetuses of their age, with 6 percent of stillbirths occurring in the lightest 1 percent.
Fetuses among the heaviest 1 percent of those their age accounted for another 1 percent of all stillbirths.
“Extreme underweight and overweight states confer the highest risk of stillbirth," the researchers wrote.
Stillbirth
is
commonly defined as death of a fetus after 23 weeks pregnancy and after
the fetus weighs 500 grams (about 1.1 pounds); in this study, the
researchers included fetal deaths that occurred after 20 weeks of
pregnancy. The researchers collected data on all births in Ontario
between 2002 and 2007 — a total of 767,016 live births and 4,697
stillbirths.Problems with the placenta can result in a fetus being severely underweight, while fetuses are most at risk for being overweight
if the mother is obese or has diabetes, according to the researchers.The researchers say their finding may help doctors assess when it might be appropriate to deliver a baby early, in cases where the chance of it surviving outside the womb might be higher than the chance surviving in the womb.
In the developed world, stillbirth
s occur
in 6 out of 1,000 births — a rate that is higher than the infant death
rate from conditions such as sudden infant death syndrome or
complications of premature birth, the researchers said.
Heavy snorers 'face double the risk' of rheumatoid arthritis
Snoring heavily almost doubles the risk of developing rheumatoid arthritis, a new study shows.
Researchers found patients diagnosed with the snoring-related condition sleep apnoea were nearly twice as likely to suffer the joint-damaging disease.
The discovery, which comes from research carried out in Taiwan, is something of a surprise as rheumatoid arthritis - which affects around 350,000 people in the UK - is thought to be triggered when something goes wrong with the immune system.
At risk: An estimated three million people in Britain suffer with sleep apnoea, though many more may remain undiagnosed
The same study found a similar increase in the risk of other so-called autoimmune disorders, where the body’s defences start to attack healthy tissues.
Scientists said they believe the explanation lies in the fact that chronic sleep apnoea can lead to inflammation in blood vessels throughout the body, which may act as a catalyst for arthritis.
Although previous studies have suggested sleep apnoea may raise the risk of heart attacks, the latest investigation is the first to show a link with arthritis.
An estimated three million people in Britain suffer with sleep apnoea, though many more may remain undiagnosed.
As sleep begins, the muscles in the airway relax. For most people this does not pose a problem but in sleep apnoea, it leads to a complete collapse which shuts off breathing for at least ten seconds.
It also disrupts breathing and triggers the sound of snoring as air vibrates against the soft tissue that stands in its way.
Once the brain realises breathing has stopped it sends out a signal for the airway muscles to contract again.
This opens the airway and the sufferer normally wakes with a jolt. In mild sleep apnoea, this can happen about once every ten minutes. If it’s severe, it means sleep can be disturbed every couple of minutes.
Very few people remember waking up at all because they fall asleep again within seconds.
Yet the cumulative effect is that they feel exhausted during the day, putting them at increased risk of accidents. Being overweight is one of the major risk factors.
In the latest study, by experts at the Taipei Medical University, 1,411 sleep apnoea patients were compared to a 7,000-strong group of healthy adults.
Over a five-year period, researchers monitored how many in each group went on to develop rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematous - all conditions where the immune system goes haywire and causes swollen, painful joints and flu-like symptoms.
The results, published in the journal Sleep Medicine, showed the snoring-affected group were 91 per cent more likely to develop one of the three conditions.
However, the researchers stressed that the absolute risk of falling ill was still small. Out of the snoring patients, only 2.91 percent experienced arthritis-related problems.
In a report on their findings the researchers said: ‘Our study is the first to investigate the association between sleep apnoea and the development of autoimmune diseases.
‘We think this may have gone unnoticed in clinical settings because these cases are relatively rare and may not be reported.
‘But the potential link between these two conditions should not be overlooked. Among the diseases we studied, rheumatoid arthritis had the highest risk of developing in sleep apnoea patients.’
As well as inflamed and swollen joints, arthritis sufferers also experience flu-like symptoms. In very severe cases, they can end up crippled and unable to live a full life.
But diagnosing the condition can be difficult as the early signs can be as innocuous as a slight stiffness in hand joints, often early in the morning.
Read more: http://www.dailymail.co.uk/health/article-2165879/Heavy-snorers-face-double-risk-arthritis.html#ixzz1z6lz5N5e
Beating arthritis is all in your head: Pain of joint condition can be eased through counselling
Painful: Sufferers of arthritis could benefit from psychological intervention, according to experts
Arthritis sufferers could have their pain eased by learning to cope with the condition through counselling, scientists have claimed.
Cognitive behavioural therapy (CBT) could help rheumatoid arthritis victims manage their pain by allowing them to control their debilitating symptoms.
Experts believe psychotherapy treatment works because it helps people focus on overcoming negative thoughts, which alter the way they feel.
A resulting positive outlook helps keep pain and adversity in context, allowing arthritis sufferers to cope with the condition.
The 104 rheumatoid arthritis sufferers who took part in a recent study were selected for one of several treatments.
The study, carried out by Louise Sharpe from the University of Sydney and published in the journal Psychotherapy and Psychosomatics, compared CBT with its separate components of cognitive therapy and behavioural therapy.
Patients who took part were analysed at the start, post-treatment and six months later on, where disease activity, joint function, disability and psychological functioning were measured.
The results found that cognitive therapy, which involves identifying and changing dysfunctional thinking, behaviour and emotions, was an effective treatment for rheumatoid arthritis, and that behavioural therapy was not necessarily needed.
Widespread: Rheumatoid arthritis affects almost 700,000 Britons and is said to be more prevalent in women
Clare Jacklin, of the National Rheumatoid Arthritis Society, said the organisation 'welcomes psychological intervention for people living with rheumatoid arthritis'.
She told the Daily Express: 'Existing and emerging evidence suggests it (psychological intervention) plays an important role in patient care yet very few people with RA are offered such interventions.
'Those who are, often have to display symptoms of depression before any referral is made.
'Prevention is better than cure and we believe everyone with a diagnosis should be able to access psychological support and therapy as required.'
Read more: http://www.dailymail.co.uk/health/article-2165817/How-counselling-help-ease-pain-victims-rheumatoid-arthritis.html#ixzz1z6lLwR5l
Women who work more than 25 hours a week while pregnant 'more likely to have smaller babies'
Pregnant women who work more than 25 hours a week tend to have smaller babies, according to research.
They weigh up to half a pound (200g) less than average at birth.
Scientists also found a connection between the amount of time pregnant women spent on their feet at work and the size of their babies, with those standing ‘often’ in jobs such as teaching or sales more likely to have smaller children.
Get some rest: Women who worked more than 25 hours a week subsequently had babies weighing 5-7oz (148-198g) less than average. (Posed by model)
One explanation is that more physically demanding work may reduce the flow of blood to the placenta, limiting the amount of nutrients and oxygen going to the foetus.
Experts do not know why working long hours in an office job would have a similar effect, but it may be due to stress.
Although smaller babies are not necessarily unhealthier, they are at higher risk from breathing problems, heart defects and conditions affecting their digestion. There is also evidence that they are at higher risk of learning difficulties and developmental problems later on.
The researchers from the University Medical Centre in Rotterdam in the Netherlands surveyed 4,680 expectant mothers, who were 30 weeks pregnant.
Put your feet up: Physically demanding work may reduce the flow of blood to the placenta
They were asked how many hours they worked a week and whether they ‘often’ spent long periods on their feet.
Those who worked more than 25 hours a week subsequently had babies weighing 5-7oz (148-198g) less than average. The circumference around the heads was nearly half an inch (1cm) shorter.
There were similar results for those who spent long periods on their feet while working during their pregnancy.
The authors, whose study is published in the journal Occupational and Environmental Medicine, said employers should do more to make pregnant women’s jobs as comfortable as possible.
‘Optimising the work environment is important since participation of women in the reproductive age in the workforce continues to increase,’ they said.
‘Preventive measures reducing certain occupational conditions, such as shift work, night hours, standing, lifting and noise, have proven to reduce the risks of adverse birth outcomes.’
Dr Jenny Myers, from Manchester University’s Maternal and Foetal Health Research Centre, said: ‘The observed effects are not big enough to dramatically increase the number of growth-restricted babies, but it is not known whether these very subtle changes in growth trajectory have any significance in the long term.’
Prof Alex Burdorf, the lead author, said: 'We were not surprised that (the babies') head size was smaller in pregnant women who stand for a long time at work, but we were pleasantly surprised to find that it was only by a modest amount - three per cent smaller than average at birth.'
Read more: http://www.dailymail.co.uk/health/article-2165747/Women-work-25-hours-week-pregnant-likely-smaller-babies.html#ixzz1z6imbJVm
BREAKING NEWS: Supreme Court UPHOLDS individual mandate in Obama's health care reforms
Read more: http://www.dailymail.co.uk/news/article-2166002/BREAKING-NEWS-Supreme-Court-UPHOLDS-individual-mandate-Obamas-health-care-reforms.html#ixzz
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
'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
Happy: Minority leader Nancy Pelosi Tweeted about the Supreme Court decision shortly after it was announced
Many early reports said that while he was 'confident' that the court would uphold the constitutionality of the legislation, sources with knowledge about the situation said that he was also fearing that the conservative-heavy court may strike down the individual mandate portion of the law.
The theory behind the mandate permits that by forcing all Americans to buy health insurance, it will lead to fewer emergency room visits by uninsured individuals which would keep hospital costs down.
Conservatives argue that such a move is not only unconstitutional but also bad for business.
The fact that Chief Justice Roberts, one of the court's conservative members, wrote the majority opinion that allowed the individual mandate to go into effect, it insures the Republican party will begin attacking the court in the coming
Taking the side of small business owners, who, if the law goes into effect, would have to help cover the costs of all of their workers' insurance and would effectively raise operating costs to an extent that their profit margins would be threatened.
Awaiting word: President Barack Obama will address the decision this afternoon
TAKING TO TWITTER: REACTIONS
Sarah Palin, former Republican Vice Presidential nominee
Obama lied to the American people. Again. He said it wasn't a tax. Obama lies; freedom dies.
Rick Santorum, former Republican presidential nominee
#SCOTUS outcome is major setback for freedom & biggest permanent tax increase in our nation’s history. Elections matter.
Michelle Bachmann, former Republican presidential nominee
I'm disappointed #SCOTUS thinks gov't knows better than people. I won't stop fighting #Obamacare until is full repeal. RT if you're with me.
Erick Erickson, conservative author of RedState.com
Big loss for conservatives. Suddenly the left loves John Roberts.
Christine Quinn, speaker of the New York City council and likely mayoral candidate
The Supreme Court's decision to uphold the #Affordable Care Act is great news for our City, State, and Nation. #SCOTUS
Obama lied to the American people. Again. He said it wasn't a tax. Obama lies; freedom dies.
Rick Santorum, former Republican presidential nominee
#SCOTUS outcome is major setback for freedom & biggest permanent tax increase in our nation’s history. Elections matter.
Michelle Bachmann, former Republican presidential nominee
I'm disappointed #SCOTUS thinks gov't knows better than people. I won't stop fighting #Obamacare until is full repeal. RT if you're with me.
Erick Erickson, conservative author of RedState.com
Big loss for conservatives. Suddenly the left loves John Roberts.
Christine Quinn, speaker of the New York City council and likely mayoral candidate
The Supreme Court's decision to uphold the #Affordable Care Act is great news for our City, State, and Nation. #SCOTUS
Republican presidential nominee Mitt Romney has kept touting that line of argument, resting heavily on his business background and stressing the damage that he feels it would do to the country's struggling economy.
In the days leading up to the announcement, Mr Romney spoke extensively about the Supreme Court ruling in his stump speeches at campaign events in Virginia, New Jersey, New York, and Virginia.
'My guess is they're not sleeping real well at the White House tonight,' he said Wednesday night in Virginia.
The decision is clearly not what they were hoping for, but that does not mean that the Romney camp has little to smile about: one of his campaign managers told MSNBC that they had already raised over $100,000 in the hour following the Supreme Court announcement.
In spite of waiting for the decision to begin bombarding the airwaves with news about the ruling itself, Mr Romney's camp released ads promising that if he wins the election, he will repeal the bill from behind the Resolute desk.
The issue was initially problematic for Mr Romney during the primaries as he enacted a relatively similar scheme in Massachusetts when he was governor.
Supporting the cause: President Barack Obama made the Affordable Health Care Act a pivotal portion of his presidential legacy, so the decision will have a great impact on his re-election campaign
Controversy: Mitt Romney and the Republicans have argued that the health care legislation is bad for business and unconstitutional
After taking a beating for that decision from his more conservative competitors, Mr Romney was able to collect enough support from elsewhere in the party to move past that line of attack and focus again on the economy.
Such a move is expected in light of today's ruling as well.
One Republican strategist told Politico's Mike Allen that if health care was struck down by the Court, the best move for the GOP would be to drive the point home that Mr Obama spent much of his early time in office on a piece of legislation that is no longer valid rather than focusing on the economy and dismal unemployment rates at the time.
Read more: http://www.dailymail.co.uk/news/article-2166002/BREAKING-NEWS-Supreme-Court-UPHOLDS-individual-mandate-Obamas-health-care-reforms.html#ixzz1z6dw6MWr1z6dWCujR
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