Seven of the votes went as expected. The more liberal justices (Kagan, Sotomayor, Breyer and Ginsburg) as predicted, voted to uphold the ACA. The three most conservative justices (Scalia, Thomas and Alito) voted against the ACA. The decision came down to Justices Anthony Kennedy and Chief Justice John Roberts.
1) What did they rule?
In sum, that the Affordable Care Act (often called Obamacare) was constitutional.
2) Who voted for and against it?
Seven of the votes went as expected. The more liberal justices (Kagan, Sotomayor, Breyer and Ginsburg) as predicted, voted to uphold the ACA. The three most conservative justices (Scalia, Thomas and Alito) voted against the ACA. The decision came down to Justices Anthony Kennedy and Chief Justice John Roberts. Kennedy, often the swing vote, went with the conservative justices and said in a dissent that he would have thrown out the entire law. Chief Justice Roberts, who wrote the decision and is considered right-leaning, sided with the liberal justices and sustained the law in a 5-4 decision.
3) Why did they uphold the ACA?
The court decided the most controversial portion, which is called the individual mandate, was not allowed under Congress' right to decide interstate commerce (the commerce clause). However, the court ruled that because there is a financial penalty for not purchasing health insurance, that would be considered a tax. And the court ruled that the individual mandate was upheld under Congress' ability to tax.
4) So what does this mean?
Some of the clauses of the ACA will go into effect in 2014, including the individual mandate considered by the Supreme Court to be a tax. Some portions of the law have already gone into effect. Other well-known portions of the law include preventing insurance companies from denying coverage based upon pre-existing conditions, allowing students up to age 26 to remain on their parents' insurance and requiring companies with more than 50 employees to offer health insurance. The ACA also includes, but is much less publicized, providing more breastfeeding rooms, requiring chain restaurants to list the calorie count under their menu items and requiring doctors to report what items they receive from medical supply companies.
5) What does this mean politically?
It's a win and a loss for both sides. If you liked the ACA, then this is a win. If you didn't like it, then this is a loss. However, with the Supreme Court ruling the individual mandate is a tax could be seen as an opening for the GOP. Basically, this will not be the last word on this issue, and it will likely be a campaign talking point as the road to the election approaches.
-- Andrew Nash, for the Morning Sun