The Supreme Court of the United States upheld the individual mandate of the Affordable Care Act (ACA), according to the SCOTUS Blog, which is sponsored by Bloomberg Law.

Because the court upheld the individual mandate, the entire ACA is constitutional.

The blog is reporting that Chief Justic John Roberts was the swing vote in the decision, upholding the law as a tax. It was a 5-4 vote.

“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. This is sufficient to sustain it,” Roberts wrote in the opinion.

Justices Kagan, Breyer, Ginsburg and Sotomayor determined that the mandate is constitutional as part of the commerce clause. Justice Roberts disagreed on that point, but joined them in saying the penalty for not buying health insurance is constitutional as a tax.

The Court also ruled the Medicaid expansion is constitutional, but would be unconstitutional if the federal government  to withold Medicaid funds from states who choose not to comply with expansion.

For the court’s full decision, click here. For live updates from the SCOTUS Blog, click here.

Local Reaction:

Gov. Terry Branstad and Lt. Gov. Kim Reynolds

The two immediately bashed the decision by the court in statements saying it was a “disastrous decision” for Iowans.

“The current health care system is nothing but a federal takeover and continues to exceed its budgeted amount every day.  But, as Governor Romney has said many times, no matter what may happen in Court, the American people must remain vigilant in their fight to repeal the law,” Branstad said. “Our goal is for Iowa to become the healthiest state in the country and to do so Iowans will need to take ownership of their own health to reduce health care costs and lead healthier lives.” Full Statements

Bill Leaver, president and CEO of Iowa Health System

Leaver released a statement saying it is now time for politicians, the public and health professionals to move on from debate and work on making health care better.

“Let’s not have the upcoming election, lame duck session and 2013 Congress focus on ripping apart health care delivery provisions of the ACA that will lower the cost, increase the quality, and improve the patient experience in the health care setting,” he said. 

Click here to see his full statement

LeadingAge Iowa

LeadingAge Iowa said today in a statement that programs affecting Iowans in long care services can move forward now.

“Had the entire law been declared unconstitutional, the future would be uncertain for a number of state and federal programs affecting people using long term support and services,” said Dana Petrowsky, President and CEO. “Iowans will see benefits.”

Rep. Tom Latham 

“While the Supreme Court has the duty to determine the constitutionality of the health care law, it does not have the authority to determine if it is good or bad policy for hardworking Americans.  Thankfully, it is still the American people who ultimately have the power and the right to make that final judgment.”

Click here for his full statement.

Mike Ralston, president of the Iowa Association of Business and Industry
“One of the biggest concerns about the act for manufacturers is uncertainty about compliance and the potential for huge increase in costs. The ruling helps alleviate some uncertainty. The real question moving forward is compliance. The Congress has made at least one significant change in the act, and if there are other changes we want to work with them. We need to focus on implementation.”

Kristin Kunert, director of the Iowa chapter of the National Federation of Independent Businesses, which joined the effort to have the law ruled unconstitutional.

“We are very disappointed. We respect the Supreme Court decision, but now it becomes a tax and a tax is a broken promise from the president,” said , which joined efforts to have the law declared unconstitutional. “We think its deeply flawed, but we’ll keep working to get the right people elected to get our voice heard.”

State Sen. Jack Hatch of Des Moines
“I think all Iowans win. I think it’s a great decision not only for the uninsured, but for people who have insurance who don’t have to worry about whether they will be dropped because they have pre-existing conditions or are afraid of using all of their lifetime benefits. The small business credit will provide thousands of dollars immediately. I think we can move forward. The politics, if they want to play it out, they can.” Hatch plans to call a summit of all stakeholders to find common ground for implementing the law in Iowa.

Andrew Cannon, Iowa Policy Project
“Hopefully now that its been decided, we can move beyond talking about the politics of it and move forward with the policy decisions and see what we need to do to make this work for Iowans.” Cannon pointed out that state lawmakers have two important decisions to make: Allow the expansion of Medicaid benefits, a program that would receive 90 percent of its funding from the federal government, and whether to create a health care exchange that suits the unique needs of the state, rather that use a cookie-cutter program from the federal government.

John Forsyth, chairman and CEO, Wellmark Blue Cross and Blue Shield
“We plan to remain engaged in state-based health care exchange discussions, and will continue to provide input to policymakers as they develop the best approach to establishing a successful exchange model in Iowa and South Dakota.” In a prepared statement, Wellmark pointed out that it was one of the few Iowa insurance companies to exceed the health care law’s medical-loss ratio requirement to spend 85 percent of premium dollars on medical claims in the large group market (100+ employees), and 80 percent in the individual and small group markets.