The U.S. Supreme Court ruled on the constitutionality of the Patient Protection and Affordable Care Act (PPACA) on Thursday, June 28, 2012. In a much anticipated decision, the justices, led by Chief Justice John Roberts, found that the individual mandate requiring virtually everyone to purchase health insurance or pay a penalty is constitutional.

While many court watchers had anticipated the decision would turn on the court’s interpretation of the Commerce Clause of the U.S. Constitution, the five-member majority instead found that the individual mandate is constitutional under the taxing authority given to Congress under the Constitution. The fact that the court’s reasoning was not as many expected does not materially change the result; under PPACA, everyone must purchase health insurance or pay a penalty that will be collected and enforced by the Internal Revenue Service.

The court, in a 7-2 vote, did strike aspects of PPACA’s expansion of the federal Medicaid program. The court said that Congress could expand the Medicaid program, but they essentially could not coerce the states to participate in the expansion under the threat of losing other Medicaid funding.

In a conference call with reporters, Dan Danner, National Federation of Independent Business (NFIB) president and CEO, expressed disappointment with the ruling. NFIB was a party to the case before the Supreme Court. However, Danner also said that there are many provisions of the law that NFIB and other groups representing small business will continue to fight. These provisions include the Health Insurance Tax (HIT) and PPACA’s employer mandate. The American Rental Association (ARA) has worked in coalition with NFIB to oppose both provisions and will continue that aggressive opposition going forward.

“The court left a majority of PPACA in place. It is the law and we need to continue to work with ARA members so that they understand what they need to do to comply with the law; that’s what we do,” says John McClelland, ARA's vice president for government affairs. “Having said that, we also will continue to work hard to repeal the provisions of PPACA that we believe have a severely negative impact on ARA members.”

Going forward, ARA will continue to analyze the regulations that federal agencies are proposing as they implement PPACA, including the rules that will define “minimum credible coverage” for health plans and the rules that will govern the insurance exchanges, which are the places people will go to purchase coverage.

“While I join Dan Danner in his great disappointment in the court’s ruling today, I am also committed to making sure that every ARA member has the information necessary to make informed choices that comply with the law and are the best choices for their company and their employees,” says Christine Wehrman, ARA's executive vice president and CEO.

Click here for the full text of the Supreme Court’s decision.