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The Supreme Court has upheld the heart of President Barack Obama's health care overhaul: ruling in favor of the requirement that most Americans can be required to have health insurance, or else pay a penalty.

 

The decision means the historic overhaul will continue to take effect over the next several years, affecting the way countless Americans receive and pay for their personal medical care.

 

The ruling also hands President Barack Obama a campaign-season victory.

 

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

 

The court's four liberal justices, Stephen Bryer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

 

Ohio Governor John Kasich and Lt. Governor Mary Taylor released a joint statement in a press release about the decision:

 

"We're very disappointed that this flawed law has been allowed to stand.  The Supreme Court has confirmed what everyone knew all along-but that the White House tried to deny: this is a massive new tax on the middle class.  Hopefully Congress will eventually repeal the law altogether and replace it with improvements that actually address the most pressing needs in health care, especially the need to reduce costs in order to improve access.  Until then, Ohio taxpayers could be saddled with dramatically higher costs.  The Administration will carefully analyze the decision to determine the appropriate next steps.  We are very concerned that a sudden, dramatic increase in Medicaid spending could threaten Ohio's ability to pursue needed reforms in other areas, such as education.  Going forward, we remain committed to minimizing the law's drag on the economic growth Ohio is beginning to experience, protecting the inviolate relationship between doctors and patients, and preserving as much free market competition in health care as possible."