(CBS News) The U.S. Supreme Court has upheld most of President Barack Obama's Patient Protection and Affordable Care Act (ACA), including the controversial individual mandate that requires most Americans to get health insurance.
The law was designed to extend health coverage to the 50 million Americans who don't have insurance.
In a 5-4 decision the court said the federal government has power to fine Americans who don't acquire insurance because it's considered a tax.
In other parts of the ruling, the Act's provision that requires insurance companies to cover pre-existing conditions stands, as does an end of lifetime limits on coverage and a provision that allows children to stay on their parents' insurance until they are 26 years old. The latter part of the law is already in effect, and afound 6.6 million young adults between ages 19 and 25 stayed on or joined their parents' health plans because of the law.
The court did strike down the expansion of Medicaid to cover more people in poverty as unconstitutional. On the Medicaid issue, a majority of the court held that the Medicaid expansion is constitutional but what isn't constitutional is for the federal government to withhold Medicaid funds for states that don't comply with the expansion provisions.
"Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use," Justice Roberts wrote in the ruling. "What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."
CBS MoneyWatch reports the provision would have expanded to 16 million individuals under 65 who made less than or around $30,000 a year for a family of four. With the court prohibiting punishment for states, the government can withhold new funds from states that don't comply, but cannot withhold all Medicaid funding, according to MoneyWatch.
Medical organizations and health care professionals weighed on the historic decision.
"The American Medical Association has long supported health insurance coverage for all, and we are pleased that this decision means millions of Americans can look forward to the coverage they need to get healthy and stay healthy," the largest professional society of U.S. doctors said in a statement. "The expanded health care coverage upheld by the Supreme Court will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive. The decision upholds funding for important research on the effectiveness of drugs and treatments and protects expanded coverage for prevention and wellness care, which has already benefited about 54 million Americans."
Nancy Brown, CEO of the American Heart Association said today's decision will benefit America's heart health for decades to come.
"By upholding the law, the nation's highest court has sent a clear message that patients should be the first priority in an ever-changing healthcare arena," Brown said in the statement. "Under the law's robust provisions, we are expanding access to preventive care and medicines to reduce an individual's risk factors; placing a stronger emphasis on community prevention and wellness; and providing access to the care patients need to recover after a heart attack or stroke so they can lead longer, more productive lives."
Brown added the law will especially help the 122 million Americans with pre-existing conditions, including 7.3 million uninsured individuals with some form of heart disease or stroke.
The American Academy of Pediatrics, which represents 60,000 pediatricians, stood behind the Court's ruling in a statement.
"Today, the Supreme Court upheld a law that invests in children's health from the ground up," said AAP President Dr. Robert W. Block. "Pediatricians have already seen firsthand that health reform works," he said. "Since the Affordable Care Act took effect, millions of children with pre-existing conditions gained health care coverage; 14 million children with private insurance received preventive health services with no co-pay; and 3.1 million more young adults gained coverage through their parents' plans."
The American College of Physicians said in a statement that every American will benefit from today's Supreme Court's decision.
"We are pleased that the Supreme Court's ruling resolves the legal questions so that these and other reforms can go forward," said Dr. David L. Bronson, president of the American College of Physicians. "Taken together, these reforms will improve health care for everyone, including those of us who are already insured."
Women's health was often spotlighted throughout debates on the Act, namely the free preventive care provision which also covers contraception. The American Congress of Obstetricians and Gynecologists said in a statement it applauded the Supreme Court's ruling.
"The Affordable Care Act helps ensure all Americans have access to affordable coverage with important consumer protections and benefits, including comprehensive maternity coverage and well-woman care," said ACOG president Dr. James T. Breeden. "We urge all states to act swiftly to implement these important access and coverage guarantees."