South Florida health care experts and politicians were quick to react Thursday to the Supreme Court's decision to uphold the heart of President Barack Obama’s health care mandate.
Lillian Tamayo, president and CEO of South Florida and Treasure Cove Planned Parenthood, said they were "absolutely delighted" by the decision and said the move was the "greatest advance" for women's health in a generation.
"[Women] can start protecting their own health, saving money and having control on whether and when they are going to start their own families," Tamayo told NBC 6.
The 5-4 decision, written by conservative Chief Justice John Roberts, sided with Obama on the centerpiece of the law, which requires all Americans to have health insurance or face a fine.
The mandate was upheld under the federal government's power to levy taxes.
Tamayo said women would be able to access birth control without a co-pay, saving them $600 a year, equivalent to five bags of groceries for a family of four.
"This has incredible impact, South Florida has one of the highest uninsured rates in the country a greater percentage who have no health insurance or are underinsured," Tamayo said.
In Florida, 3.85 million people are uninsured, about 21 percent of the population.
Florida Medical Association President Miguel A. Machado said his group remained concerned about the upheld act, though.
"Health care system in our country should be focused on the needs of individual patients," Machado's statement read. "The Florida Medical Association remains concerned that the surviving Act weakens the Medicare program, fails to substantively address medical liability reform, and dramatically increases the regulatory burden on physicians and patients. These issues hinder access to quality health care and the FMA looks forward to working with elected officials to repeal those provisions that are harmful to our patients.”
Gov. Rick Scott said the ruling was "disappointing" and called the central provision of the Affordable Care Act "a new tax."
"With the national economy struggling to recover, now is not the time to implement a massive social program that injects nothing but uncertainty and doubt into our economic system. By doing so, they have put up yet another major roadblock to efforts to get people back to work and forced the government into the important relationship between patients and their doctors," the Republican said in a statement.
Florida was the lead state of 26 that sued to overturn the law. The court's decision to uphold most of its provisions appeared to flummox the governor and other top state officials.
"Were we expecting this ruling? No, of course not," said Attorney General Pam Bondi, who had pushed to hire the attorneys used by the state to argue the case before the Supreme Court.
Thursday's decision had an immediate impact on the presidential race, as Obama and his Republican rival, Mitt Romney, seized on it in sharply different ways.
"Today's decision was a victory for people all over this country whose lives will be more secure," Obama said at the White House. "It's time for us to move forward."
Romney, meanwhile, asked voters to render their own ruling in November.
"If we want to get rid of Obamacare," he said, "we're going to have replace President Obama."
Congressman Connie Mack told NBC 6 he was "shocked" and "angry" at the ruling and said the Obama administration had put forth "a disgusting tax" on the people.
"Right now we have companies in the state of Florida that don't know what this is going to cost them, what it's going to do to their five-year business plan," the Republican said. "Employers are having to decide, not only whether or not they can keep the employees they have, but certainly it makes it much more difficult for them to hire new employees," he added. "The only way to solve the problem is to repeal ObamaCare."
On the other side of the aisle, Democratic Congressman Alcee L. Hastings called the ruling a "victory" for the American people.
"This decision upholds the principle that all Americans should have access to affordable, quality health care," he said.
Republican Florida Senator Marco Rubio issued a statement Thursday responding to the Supreme Court's decision.
“What’s important to remember is that what the Court rules on is whether something is constitutional or not, not whether it’s a good idea,” Rubio said.
“And while the Court has said that the law is constitutional, it remains a bad idea for our economy, and I hope that in the fall we will have a majority here that will not just repeal this law, but replace it with real solutions that will insure more people and cost a lot less money,” he continued.
In a speech later on the Senate floor in Washington, Rubio predicted that Obama's health care bill would hurt the economy.
"You’re going to see it in a further downturn in our economy, in more slowing in economic growth. This is going to have a real impact," he said, calling the health care law "a middle-class tax increase."
Scott ordered the state not to accept federal money for implementing the health care law after he took office last year. Florida has rejected or declined to pursue more than $106 million and has returned $4.5 million.
The state has its own health insurance exchanges, mainly for small businesses but without an individual mandate. The state has not implemented an exchange that would meet the requirements of the federal law.
On Wednesday, Scott was unprepared to say how and when the state would implement some of the law's requirements.
"I want to look at what the decision was and how it applies to the state and what are options are," said Scott, a former hospital chain CEO who, before he ran for governor, put together a group that ran television ads in opposition to the health care overhaul.
Bondi said in a statement after the decision was released Thursday, "All of us who are disappointed with the ultimate outcome today cannot lose sight of what we accomplished. We fought for the principle that the Constitution limits Congress’s power to direct the lives of our people, and on that point, we won. As Chief Justice Roberts wrote in his opinion for the majority: 'The Federal Government does not have the power to order people to buy health insurance.'”
Bondi added that seven justices agreed with Florida's position that Congress cannot force states to make what she called "the unacceptable choice between losing all our Medicaid benefits or accepting a massive, unaffordable expansion of the Medicaid program."
The court's move striking down the part of the law allowing states to now opt out of expanding Medicaid coverage for the poor is important, said Michael Froomkin, a constitutional law professor at the University of Miami.
“It said that the penalty for states to choose to opt out of the Medicaid expansion is basically zero,” he said.
Scott said that taxpayers would not be able to afford the health care overhaul, but he would not say if he would support or oppose expanding Medicaid.
Dr. Laurence Gardner, an expert on public health policy at the University of Miami, says that if the health care reform law remains in place through 2014, when the big reforms kick in, consumers who don’t already have health insurance can expect a radically different landscape for it.
“It will mean that insurance policies will be easier to obtain. You won’t be overcharged if you have a preexisting condition," Gardner said. "If you’re under 26, you’ll continue to be covered by your parents’ insurance. And that insurance companies actually have to spend at least 85 cents of every dollar they get paid in providing care to you, and if they don’t, they have to give the money back."
Even after the law is fully implemented, an estimated 26 million people are expected to remain without health coverage, including illegal immigrants, people who don't sign up and elect to face the fine instead, and those who can't afford it even with the subsidies.