The Supreme Court on Thursday upheld all parts of the Patient Protection and Affordable Care Act.
The decision was written by Chief Justice John Roberts, who joined the court's four liberal justices in upholding the law.
The key was support for the provisions which requires everyone to buy insurance or pay a tax.
“Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax,” Justice Roberts said in the opinion. “This is sufficient to sustain it,” Justice Roberts said.
However, industry officials and analysts caution that the ultimate decision will be left to the voters.
They also caution that even if President Obama wins re-election, implementation of the health exchanges, a key component of the law, could be delayed, perhaps a year.
Beth Mantz-Steindecker and Ira Loss of Washington Analysis, said, “Despite the settlement of the constitutional question, the ultimate fate of the healthcare reform law remains to be seen, which will be determined in large part by the outcome of the November elections.”
The decision did allow states the option to not to go along with the expansion of the Medicaid insurance program for low-income people.
George Patton, an appellate lawyer with Bose McKinney & Evans LLP, of Washington, D.C. and Indianapolis, said under the decision, states can choose to expand Medicaid to 133%, but they are not required to.
Congress cannot “penalizesstates that choose not to participate in that new program by taking away their existing Medicaid funding,” Roberts said in the majority opinion.
The Medicaid provision is projected to add nearly 30 million more people to the insurance program for low-income Americans.
Elizabeth Festa contributed to this report.
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