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WASHINGTON -- The Supreme Court upheld the Affordable Care Act and its main provision, the individual mandate.

In a 5 to 4 decision, the Court said Congress does have the power to require Americans to have some form of health insurance. Those who refuse to carry insurance will pay a tax.

Chief Justice John Roberts joined the liberal wing and delivered the opinion of the Court.

The Court limited Congress' power to force the states to expand the Medicaid program, saying Congress cannot "penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."

Four justices, including Anthony Kennedy, dissented. Kennedy said, in the first line of his dissent, wrote, "In our view, the entire Act before us is invalid in its entirety."

The Supreme Court's decision to uphold President Barack Obama's sweeping health care law is a crucial election-year victory for the Democratic incumbent.

It also marks a pivotal point in the presidential race.

For Obama, the decision vindicates his most significant legislative accomplishment.

Republican challenger Mitt Romney opposes the health care overhaul and is expected to double-down on his campaign pledge to repeal the law if he is elected.

The high court announced Thursday that it was upholding the individual insurance requirement at the heart of the health care overhaul.

Obama calls Supreme Court ruling a 'victory'

Obama said the Supreme Court's decision to uphold his health care overhaul is a "victory for people all over the country" and will make their lives more secure.

Obama said the decision upholds the fundamental principle that in America, the wealthiest nation on earth, no one should fall into financial ruin because of an illness.

The president said the decision means that people with pre-existing medical conditions will not be discriminated against and people will be able to afford quality health care.

The nation's highest court on Thursday upheld the individual insurance requirement at the center of the president's overhaul.

Polling has suggested that most Americans oppose the law and Republican presidential candidate Mitt Romney vowed again after the ruling to seek its repeal.

Romney: Supreme Court ruling on health law wrong

Republican Mitt Romney is promising that he will repeal the federal health care law the Supreme Court just upheld.

He called the decision incorrect and said Thursday that it is ``bad law.'' He says it raises taxes and cuts Medicare.

Romney says that, if elected in November, he will work to repeal and replace the law. But he hasn't said precisely how.

As Massachusetts governor, Romney signed into law a measure that required all state residents to have health coverage. That notion was the cornerstone of the law enacted by President Barack Obama and congressional Democrats. The high court decided it was constitutional.

Hospital stocks jump after health care ruling

Stocks of hospital companies are moving sharply higher after initial reports said the Supreme Court upheld the individual insurance requirement in President Barack Obama's health care overhaul.

HCA Holdings stock is up 10 percent. Community Health Systems is also up 10 percent.

Stocks of drug companies and medical device makers are slightly lower for the day as analysts sort through the Supreme Court's ruling. Stocks of the biggest insurance companies are also lower.

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