The 5-4 vote may only "throw gasoline" on the polarization of our Nation. Needless to say, this will not be a popular decision in Saint Charles County. Personally, I have been in support since the campaign trail of 2008.

No opinion. See what it does to stock market today. Then watch how it effects the US economy and company sponsored Health Benefits. That is corporate America's voice.

President Obama did what Bill and Hillary could not, and something the Republicans would never offer in a lifetime.

It's interesting mike mentions polarization. That I believe is this countries downfall, I understend the need for coverage but what I would prefer is the insurance companies to develop a standard health insurance based on the principle of liability meaning covering medicine and Dr visits at a set rate to cover minor medical problems. People just have to decide what's mire important full coverage or liability.

Does ANYONE have a clue about what this really means?? HELLO! Not only is this unconstitutional in so many ways but think about your pocket books IF you are working. Where else is the money going to come from? WAKE UP, people.

The States can mandate that we have insurance on our automobiles, why would we not have mandates on insurance for our personal health? This should be no surprise. The health insurance and drug companies are far too powerful in our society!

Linda, you are correct!

The Founding Fathers must be spinning in their graves. This unconstitutional abuse of Executive powers is blatently Socialistic if not a complete act of treason against the rights of the citizens of this country. Hopefully, enough people will wake up before the next presidential election and vote this puppet master out of office before he strips us of more of our rights and the freedom to chose.

Fun observation: It seems a number of people object to Obamacare as being "unconsitutional." The fact that the court ruled that it was, in fact, perfectly legal doesn't seem to have changed any opinions on the issue. Large numbers of people with absolutely NO legal background are now going to keep calling it an act of Tyranny or Treason or Socialism or Whatever, despite the highest court in our nation saying basically the exact opposite. So what's the point of using the court if we are just going to throw a Socialism tantrum anyway?

Since MoHealthNet (Medicaid) is only available to low income children, pregnant women, disabled on Social Security and those over 65 ,others who are low income or who have no income will will not be able to buy insurance. The provision to expand Medicaid in the states was struck down. I dont see how the program can work without this key piece. As a social worker, I deal with lack of health care problems all the time with my clients. I can see both the good and the bad of the program and as a conservative, I dont think its the best solution as it stands today.

Interesting to stand back and read the temper tantrums by those who don't get their way. Could be, they cannot accept majority rule unless the rule is in their favor?

Devon, I would think it is closer. We live in the wealthiest, most prosperous democracy in the world. For that democracy to provide measures assuring that no American's must die because they can't afford to pay their medical bills is of great comfort to me.

What, precisely, do we feel the founders would have objected to? Because, I can tell you they also objected to popularly electing Senators. They objected to suffrage rights for women and non-property holding males. They objected to political parties. I'm not sure they ever went on record objecting to a law stipulating that all Americans purchase cheap healthcare plans from a private company. And even if they had, so what? They didn't know everything and our nation is one that develops and grows with time. Let us allow that the founders never formulated an opinion on healthcare, as it was never a relevant issue in their time. But let us also allow that wealthy democracies are perfectly capable of providing universal healthcare without subjecting their citizens to backbreaking tyranny.

The bill will help me personally (at least the no preexisting conditions part), however, it is a horrible decision for the country and our children who will be consigned to live in a nation without jobs. The market is swooning on this news. We needed reform, this was not the reform we needed. That sucking sound you hear is the massive number of new jobs moving off-shore. The biggest winners are the Congressional Aides who snuck in a provision to forgive their own student loans. It's in the bill. Why? Hopefully, the next Congress will strip this bill of its bad parts and keep the good.

WOW! Why isn't Devon Seddon our President!! He obviously has ALL the answers to fix this country. LOL

Everyone has these answers. Follow the money & track results.
You have to be elected to be President. No one votes for common-sense anymore, only what they percieve themselves to be getting, it's like the mirror in Harry Potter. They seem to forget that anything the government gives away, has already been taken from someone else.

Remember in November.... if we make it that far.

Why can't we follow Canada? I don't know exactley how heath care works for them, but it works for them. I guess because of all the spending with the useless wars and orbit funding this is the only way. I don't care what is going to happen in 2050 from the sky, I'll be gone by then. I do care about these people they have sent to a useless war who have lost body parts and normal fuctions. They barely help them but a civilian is required to pay for insurance. Sorry the US has had it's credit rating lowered, but all you people getting big fat paychecks for life, and free insurance. Who are you kidding. Maybe you all should pay for insurance too and see how it feels. Medicade and Medicare were put in place for people many years ago. And now you are trying to reform it to make it go away. Do you think that someone who relies on Medicade or Medicare can actually afford to pay insurance when you take that away. What is this was happening to your mother> Or your disabled child. I am 42 years old, and now their may be no social security. What did you people do to us. I have paid in my since I started working and now I don't dearve to retire until I am like 90 years old. But lucky you big fat paycheck people, if I go before then your kids are richer. You **@%%%'S

There is a huge, huge gap, and because of people who don.t belong and their mistakes and greed. This won't be right even for my kids who are 24 and 26 now. I guess they can't retire until they are 90 either or have a good life until with all these taxes and blah blah blah. What abou the gas prices? Lets talk about that. Who's pocked are getting fithfy rich there? While us the small people continue to lne their pockets, because we have no other choice if we want to get to work and pay them more taxes. The Macdonalds Dollar menu is the only thing that is going to feed people. Then people get fat because of fast food, then you want to hose us down for that. Freaking get real.

Traveling in Ireland this summer (lucky us), my daughter needed an inhaler for her asthma. We managed to get a script via internet from her Dr. The price for the inhaler (name brand) had the script filled at a Irish pharmacy. Cost? About $9. American dollars. When I fill it here, my insurance company pays $150. and I copay $35. The Pharmacist in Ireland says that the US pays so much for the same drugs because the Drug Companies rule.

Is healthcare a right? If it is, it probably ought to be free. I it's not, we probably ought to have to pay for it. In most things in life, you do get what you pay for. Given a choice, I'd rather eat a filet mignon as opposed to a McDonalds hamburger. Sometimes I can't afford the good stuff. However, at least I have a choice. The challenges to this law certainly aren't over, but I would rather have access to the best quality healthcare on planet Earth, even if I have to pay more for it. This law will eventually make sure I don't get my choice anymore, and that makes me sad.

The Ireland drug example is a very scary story for the future of drugs in Ameica. Obviously, we who actually pay for our stuff here in the US have been subsidizing the world over their medications. If we stop, what hope do we have for companies to spend billions to test new compounds and get them approved? We'll be more reliant on government to pay for all that research and for what they deem worthy of taking even more of our tax dollars.

Having worked in healthcare most of my life, I am very pleased with the Supreme Court decision. I have never understood why health insurance coverage is tied to your employer.......... As for the socialism arguments, the government provides free education for children & requires they attend school until age 16 - is that socialism? As a "developed country" - don't we owe all citizens a few basic necessities?

For those who are screaming this as unconstitutional, when did you get nominated, vetted and accepted to become a justice of the Supreme Court? They determined most of it was within the means of congress to pass it. Obama didn't just sign this in the book when the congress on their many recesses. The way it was worded, was well within the power of congress as above mentioned. The way things are worded are the way laws and rules are written have everything to do with the way laws if challenged are upheld. That is the way the forefathers intended this republic to work, that is why there are three branches to the government. We all just witnessed the way it works first hand, if you don't like it find a place to live that doesn't have the government set up this way. For those that don't understand insurance if more people pay into ( oh they will pay into it just the way people pay into medicaid and medicare by percentage of the income you earn) the less that insurance is going to cost. And if you have insurance through your employer then there will be no need for ObamaCARE for you. But in theory it should lower premiums and actually created jobs in the medical field. Because the more people getting care, the higher the need for medical professionals, in all fields, Billing, Nursing, Pharmacy, etc.

Just my two cents.

First Tea Party protest after the ruling, in St. Louis at the Art Museum. http://www.winningwebvideo.com/567/first-tea-party-protest-after-health-care-ruling/

You left out the tax-increase again. Must be an epidemic.
You forgot to add the tax-increase to the cost of your new "cheaper" insurance.
The Supreme Court ruled this was a tax, you know, the part you are all forgetting.
That is what got it passed. It was ruled a tax-increase. (The largest one ever, too)
Did you mean the "way it was worded" was as a tax-increase?

Wait, At one point "we already paying for people who can't afford insurance" (the reason always given for doing this)? Then it's "more people getting care" (the contradictory other reason) while their taxes go up also? It seems like these 2 reasons keep colliding.

I guess this also puts to rest the "No tax increases for people who make less than $250,000/year" promise.

Call me what ever you what to call me, or disagree with me. There are cures for Aids, Cancer Etc. So much money is raised and donated for this research and has been for how many years. (no cure yet?) While our loved ones die off and they make a bunch of money on hopefull drugs. Really. If after all these years, people are in these jobs to find cures, and they are not, but have their own stable lifes raking in all this money. Hello, they have the answers, they just make toooo much money to . Give them to people, stop playing games. They make tooooooo much money off the medicine which is not helping.. Have any of you people read the side effects of all the drugs they have that Don't work. Do yo want to have a stroke or memory loss or kidney failure? Everything is about heathcare. But what about the people who are being paid to find cures? If they were doing their jobs correctly, heath care might not be so high. It is under rated and under under educated.

Elizabeth, check and see if the penalty is just for people who can afford healthcare but choose not to buy it until they need it.
You are wrong about Healthcare is not and never has been "tied to your employer". History tells us that after WW2, there was economic growth in the US and companies began to offer free health insurance in order to get top people to work for them. You could turn down this free service and get your own, but buying the most costly medical insurance in the whole world would not be advisable.

Sonny - regarding your comment about the penalty, I have to assume that you were responding to my comment on the taxes in the law? To clarify, I was talking about the 20+ taxes included throughout it. Like new taxes on the medical equip. manufacturers. The "cadillac" tax which in some cases may be as much as 40%. Don't forget the extra tax on self-insured plans. There are several taxes in this bill that you may think won't affect you, but if the companies who make MRIs get hit with a 15% increase, they will pass that cost to the hospital who will pass it to the insurance co. (who then gets hit with a couple different tax increases of their own) who will pass it to your employer, who will pass it to YOU. By the time the fee gets to your pocket/paycheck it will be more like 25%. But hey, make less than $10K personally or $19K as a family there is no penalty for not having insurance (persons @ this income level already qualify for Medicaid) there is no penalty for not having health insurance. Make more than that & there IS a penalty. To the tune of 1-2.5% of your annual income depending on the year (it is a graduating scale). After 2016, the penalty increases annually in accordance with the cost of living. That doesn't change the effect the built in taxes will have on the cost of heath care or health insurance premiums though. Premiums will still be higher and costs will still go up. Did that answer your question or did I misunderstand what you were asking of me?

You did a good job, but I heard the med equipment tax is only 2.3% and it would be passed along, similar to a sales tax. Also, if you claim to have health insurance on your tax form, there is no additional tax. Question: In 2013, what is the minimum annual income to owe the 2.5% tax penalty for not having health insurance?

Also, I agree that people should not get health insurance from their employer. I wish the companies would give 80% this cost directly to the employees so they would be on a level playing field with the rest of the world. Then the employees and every other American could buy into a non-profit single payer system.

Devon - If you and your kids don't support a universal health system, there may be unhealthy consequences when large number of people don't get adequate treatments.

Also like millions of people, if I add up all my insurance premiums, subtract what they've paid out, the amount I lose is usually a negative amount. I guess you might say that is a winning amount, but being sick is not a win. I'll end with a quote that I heard somewhere. "Whatever you do for the least of my brothers, so you also do unto Me."

Passed along. Is that the same as "trickle-down"? Yes. An idea that all of the Party-line people firmly disagree with when it comes to job creation & economy-building, but it works here. Ironic isn't it? No. They do it all the time.
That's why they never address how we got here. Too much government, tax & regulation, creating a smaller tax-pool, even from the highest corporate tax-rate in the world (as of April), then calling for more of the same to fix it.
This is a government "take-over" 1/6 of the economy all at once in an effort to fix the fact that they've taken over too much already, effectively ruining the economy. There's no way around that unless you ignore the "means to the end", which they are always sure to do. This is just another, and will result in these same people asking the government to come in & fix future problems (they themselves have single-handedly created).
Even then, they will still be arguing that this isn't socialism, and they will still be wrong. Our forefathers warned us of this (but they didn't know everything), it's never worked anywhere in the world (but ours will somehow), it's going to cost everyone more (but premiums -they claim- will go down)... It's on & on, with them. They can only think what their party tells them to think. That's why they always send you to some "link" where they got their opinion, pull things out of context or attack how you address the issues. Not the issues themselves. It's mis-direction, plain & simple.

How about this, I won't ask you to pay for my doctor bills, I just ask you to extend the same courtesy.
So you're telling me that the insurance companies don't make any money, they pay out more than they bring in? I don't buy that for a second.
I've taken care of myself and my kids without insurance. It seems stupid to pay someone else, then have to fight with them, ususally talking to some idiot who is trained to give me the minimum amount they can, all to get my OWN money back. NOW, we've invited in the world's most wasteful consumer, to simply be ANOTHER middle-man taking their cut. There's nothing smart in this anywhere.
Again, you forgot all the tax increases. This isn't free. There is nothing free about it, and the government is not giving you anything, stop pretending it is.

@Big John - There is a vast difference between having the right to own something and requiring someone to provide a service to you. However, setting aside my more libertarian argument on that issue I have to say that even without the ACA you were free to get health care. So your argument in support of the new law based on the idea that it is a right is moot. Your ability to seek health care has not changed. Who pays for it may have, but your "right", as you put it, was already in force. You're simply clouding the true issue which is should the government have an even bigger hand in something as private as health care and should they go about granting themselves the authority by means of an enormous, convoluted deceptive piece of legislation that by Nancy Pelosi's own admittance was "passed in order to find out what was in it." Seems that (in your words) Republicans aren't the only posters here who are suddenly Constitutional law experts.

I think we need to step back and look at this decision with a cool head. First, the Affordable Care Act should be referred to as ACA and not a political tag being used to divide us as pawns in a presidential chess game. Next, assess the current problems with healthcare. U.S. ranked is ranked dead last of countries with highest economies. Major issues needing change: Cost, quality and excess.
Cost - Insurance premium higher because of: pre-existing condition, older children covered. Non-medical expenses over 80% must be returned to customers.
Quality - initial rationing, prevention rather than cure coverage
Excess - Medicaid expansion of 17 million. major implementation problems
We need to tackle this large change one step at a time. The ACA provisions are being implemented a little at a time. The law can be changed when there is proof that any part of it is not working. We have all the leading countries in the world to use as examples of what works and what doesn't.

A smarter, more appropriate approach to the health care problems in our country would have been to take small steps and adjustments as time went on, not pass a behemoth piece of legislation so large and complex that it spans 2400+ pages and then attempt to tweak it along the way. Yes, there are issues that need repair. Let's start with why can't insurance companies sell policies across state lines? Why wasn't there some sort of tort reform as part of the ACA? And as far as older children being covered, age 21+ is not a child. By age 26 I already had my own family that I was taking care of. Prior to this law, students could remain on their parents' policy while they were registered as students until age 24. What's 2 more years? Premiums are going to go up across the board. Rationing? I'm confused. Are you OK with rationing as long as we get it out of the way up front? Please explain. So what exactly have we gained? Higher premiums, the government deciding what treatment you need? Fees for not buying a product? Having read more than I care to think about of the ACA I have zero faith in the IRS's ability to manage it.

Elisabeth - I too asked the question, "why can't insurance companies sell policies across state lines?" But I am satisfied with the response that it would be a race to the bottom for quality healthcare. The race would start out even with our current insurance companies competing with quality care. Then a clever manager will figure out how premiums can be lower by simply lowering coverage. I hear McDonald does that now for their part-time employees. So, when this happens, hospitals costs will rise because of all the non-covered services and we will be back to the current situation. The only thing that I can think of is universal healthcare, but that has big government problems. We would need to keep our state regulations. We also need to get over the bad word, "social medicine" and figure out how to regulate the cost, quality and access.

Devin - What is your source for "a $500,000,000,000 tax, again, the largest tax increase ever". You should be suspicious about such big claims. A history of tax increases shows the Affordable Care Act as 6th highest (similar to Clinton's rescue of our economy and only 1/2 that of Reagan's rescue). In addition, the tax will NOT be imposed on 93% of our citizens, so it won't hurt the economy, it will help.

Sonny - You are naive if you believe that 93% of citizens will not be affected by the taxes in the ACA. Even if they are not taxed directly they will end up footing the bill as the increased costs will be ultimately passed down. Ironically, undocumented workers are exempt from the penalty for not having insurance. So in essence, 100% of those affected by taxes and / or penalties called for in the ACA will be citizens. Just out of curiosity, what source did your 93% statement come from?

Elisabeth - I don't remember the organization that produced the figure. They said only 7% of the country would have to pay tax. I'm not sure if which tax they were talking about - the tax that pays for ACA or the tax penalty for not buying insurance.

I won't have to pay the 3.8% surtax on "investment income" because my adjusted gross income is not more than $200,000 ($250,000 for joint-filers) where investment income is dividends, interest, rent, capital gains, annuities, house sales, partnerships, etc. Also this income limit of 1/4 million dollar means I don't have to pay 0.9% surtax on Medicare taxes.

I don't plan to put more than $2,500 in a Flexible Spending Account, so no change for me.

I don't meet the Itemized-deduction limit now, so raising it from $7,500 to $10,000 does not effect me either.

I don't pay the 10% penalty on non-medical withdrawals now, so the 20% penalty does not effect me.

Until the healthcare industry is regulated to keep costs down, it doesn't matter in the least if insurance is "mandated" or not. The problem is not uninsured individuals, the problem is that we seem to think we MUST have insurance - and the healthcare industry feeds into that. It's a system of fear. I spoke with a radiologist in another country recently, and there they charge approx. 10% for an equivalent US procedure - he was appalled at our prices. Only in America can different folks be charged different prices by the same doctor/hospital/company. We wouldn't put up with that in any other industry, would we?

If you were in line at the pump, and you had to pay 3.15 per gallon but the next person got gas for $2.15, wouldn't you protest? Wouldn't you call it a racket?

As long as we tacitly agree to pay $20 for a pill that costs 5 cents to manufacture - yes, even taking into account R&D, we exacerbate the problem.

Elisabeth - There is no penalty for not buying healthcare insurance if you make less than $9,500. Incomes lower than $37,000 have to pay $695 per person; below $50,000 its $1000; and below $75,000 its $1600 or $134/month. However, if you are exempt from Social Security, employer's plan greater than 8% of your pay, member of Indian tribe, or suffer hardship, then there is no tax.

I just found out that the 2.3% medical device tax is only for items costing over $100. I don't remember paying that much for anything.

Sonny - Do you purchase branded prescription drugs? Those manufacturers are looking at a tax based on the sales they make of those drugs. Medical equipment manufacturers are facing a 2.3% tax. Additionally, if you have a healthcare plan considered a cadillac plan, you can look forward to an excise tax beginning in 2018 that is figured at 40% over the threshold. Check out this site for a better explanation....http://www.seiu.org/a/healthcare/frequently-asked-questions-excise-tax-on-high-cost-health-plans.php. Even if you don't use the things I mentioned, your premiums will be adjusted (passed on) to compensate for the increased costs. You can pretend it is free all you want, that doesn't make it real.
If this were the land of sunshine & kittens & you happen to miraculously fall into some magic bubble that shields you from any negative affects from the ACA there are still PLENTY of middle class Americans who DO use the HSA, who will be affected by the decrease in medical claims credits, who ARE small business owners who will be hit for capital gains (gains on paper don't always mean cash in hand. sometimes it is simply based on the increase in property value at a manufacturing plant). Personally, there are things about the ACA that will benefit me, but I wouldn't have voted for a law that hurts someone else for my own gain. Especially when the people most likely to get hurt are average people like myself. Nothing is free....someone is paying for it.

Elizabeth - I didn't mention that you can no longer pay for over-the-counter medicines from a pre-tax Flexible Spending Account. And there is a 10% tax on indoor tanning services. WOW. No wonder this law took so many pages.

Robin - You are correct when you say, "Until the healthcare industry is regulated to keep costs down, it doesn't matter in the least if insurance is "mandated" or not."
When the US mandates that emergency rooms must care for anyone regardless of insurance or not, then we already have "universal healthcare". The difference with other parts of the world is their people do not have to deal with 'profit driven' insurance companies. The other thing we lack is tighter control on healthcare fraud. You are right to question how the rest of the world gets their healthcare so much cheaper.

Exactly! If everyone is "entitled" to healthcare, then profits shouldn't enter into it. We've all heard the same tired arguments that R&D drives costs. Bull. Salaries drive costs - but those are somehow deemed "necessary."

Furthermore, if I can go to a walk-in doc and pay $30, which I have done, how can another doc possibly justify billing me $150 without health insurance OR billing my insurance company $200 and charging me a $50 co-pay?

Fix this garbage, healthcare is fixed.

Sonny Pondrom, so nice reading your comments without all the political rhetoric, sound bites and misinformation some are passing on here.

How do you like these taxes? There is more to come.
Taxes that took effect in 2010:
1. Excise Tax on Charitable Hospitals (Min$/immediate): $50,000 per hospital if they fail to meet new "community health assessment needs," "financial assistance," and "billing and collection" rules set by HHS. Bill: PPACA; Page: 1,961-1,971
2. Codification of the “economic substance doctrine” (Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. Bill: Reconciliation Act; Page: 108-113
3. “Black liquor” tax hike (Tax hike of $23.6 billion). This is a tax increase on a type of bio-fuel. Bill: Reconciliation Act; Page: 105
4. Tax on Innovator Drug Companies ($22.2 bil/Jan 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year. Bill: PPACA; Page: 1,971-1,980
5. Blue Cross/Blue Shield Tax Hike ($0.4 bil/Jan 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services. Bill: PPACA; Page: 2,004
6. Tax on Indoor Tanning Services ($2.7 billion/July 1, 2010): New 10 percent excise tax on Americans using indoor tanning salons. Bill: PPACA; Page: 2,397-2,399

Obama has not lowered the deficit OR stimulated the economy, and his policies do not help the middle-class no matter how many times he tells you they do. He will never tell you how he's doing it, either. He always says what he supports, and always tells you that his opponents don't, but he never tells you how. I wonder why that is.
Truth is, he continues to attack employers, which whether you like it or not, attacks employees -> the middle-class. You're buying the rhetoric because you are somehow emotionally tied to it, but facts don't have emotions.

Devon,
Why don't you give us facts, like John Doe did above? Saying the "truth is" is really saying, "my opinion is".

I believe the ACA will cost me nothing because I already have insurance and plan to use the Missouri exchange next year. I'm expecting to reduce my healthcare cost next year instead of the annual increase. I'm also happy that the insurance companies will have more business when almost 1 million additional Missourians will be covered next year.

"A government big enough to give you everything you want is a government big enough to take from you everything you have."

Gerald Ford, 1974