The Supreme Court on Thursday upheld the individual insurance requirement at the heart of President Barack Obama’s health care overhaul.

The decision means the historic overhaul will continue to go into effect over the next several years, affecting the way that countless Americans receive and pay for their personal medical care. The ruling also handed Obama a campaign-season victory in rejecting arguments that Congress went too far in requiring most Americans to have health insurance or pay a penalty.

Chief Justice John Roberts announced the court’s judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans. Roberts provided the swing vote to uphold the president’s health care law as the court ruled 5-4. The court’s four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

The justices rejected two of the administration’s three arguments in support of the insurance requirement. But the court said the mandate can be construed as 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,” Roberts said.

The court found problems with the law’s expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states’ entire Medicaid allotment if they don’t take part in the law’s extension.

“The act before us here exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding,” the dissenters said in a joint statement.

The court’s ruling has a far-reaching impact on the nation’s health care system. With the law being upheld, about 30 million of the 50 million uninsured Americans would get coverage in 2014 when a big expansion begins.

Obama has vigorously defended the health care overhaul as critical to the public’s health and well-being in campaign events this week.

“I think it was the right thing to do. I know it was the right thing to do,” he told supporters in Boston.

Republican campaign strategists said presidential candidate Mitt Romney will use the court’s ruling to continue campaigning against “Obamacare” and attacking the president’s signature health care program as a tax increase.

“Obama might have his law, but the GOP has a cause,” said veteran campaign adviser Terry Holt. “This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history.”

Romney so far has spent little time crafting a comprehensive plan to replace the overhaul. And the Obama campaign already has seized on Romney’s opposition to the most popular provisions in the law. For example, Romney would not prevent health care companies from denying coverage to new customers with medical conditions. Nor would he force them to cover young adults on their parents’ plans through age 26.

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