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With the Supreme Court ruling Thursday to uphold major tenets of the Affordable Care Act, some clarity is finally emerging for employers and providers, but the political battle over health care reform will likely continue.
At the heart of the ruling is the court's determination that the individual mandate, which will require most citizens to purchase health insurance or face a fine, is constitutional because it is essentially a tax, which the federal government has the right to levy on interstate commerce.
Opponents of the law had maintained that the mandate violated the Commerce Clause of the U.S. Constitution because it forced people to purchase a product they may not have wanted or needed.
But Chief Justice John Roberts, in the majority opinion, said while Congress does not have the right to force people to purchase insurance, it does, in fact, have the right to imposes a tax on those who don't purchase insurance because it's not a requirement, but a tax.
"Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," Justice Roberts wrote.
The decision means the huge overhaul, still only partly in effect, will proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care.
The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Justice Roberts in the outcome.
Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.
"In our view, the entire Act before us is invalid in its entirety," Justice Kennedy said at the beginning of his dissent, according to SCOTUSblog, which is sponsored by Bloomberg Law.
On a political level, the ruling is seen as a a campaign-season victory for President Barack Obama, although Republicans say they will continue to challenge the President and the law itself at the polls in November. House Majority Leader Eric Cantor today said a vote to repeal the law is set for July 11.
On a practical level, local health care providers and insurance experts said there is now much-needed clarity, at least for now, as employers and municipalities across the state attempt to adapt to ever-evolving regulations. Several providers praised the ruling.
"It is truly a great day for our country and for the health of our community," said Naomi Fuchs, chief executive officer of Santa Rosa Community Health Centers, the largest federally qualified health center, or FQHC, in the region. "This is a profound step towards equal access to health care. Santa Rosa Community Health Centers is prepared to serve all those in need of high quality primary care."
Health care providers have been planning for an influx of primary care patients as a result of the Affordable Care Act, particularly the region's FQHCs. Earlier this year, several received grants totaling $11.8 million to fund clinic construction as part of a national program under the health care reform law.
The region's largest hospital operator, St. Joseph Health, also offered support for the decision, even though hospitals across the country face reduced reimbursement rates for care because of health care reform.