Health service suppliers applauded the court's decision, while the health insurance industry didn't consider it as good news. Xu said although the number of insured people will increase, not every insured person has the ability to pay. Besides, according to the law, insurance companies cannot refuse an insured person even if he or she has a history of disease, which means insurers will no longer have the freedom to choose who they insure.

The ACA also says state governments, together with the federal government, will have the obligation to support those who cannot afford health insurance. State governments have said according to the U.S. Constitution, health insurance is the responsibility of the states, and the federal government has no right to intervene. That is why 26 states have challenged the ACA. The Supreme Court, however, limited the law's ability to expand Medicaid, deciding that the federal government cannot withhold a state's Medicaid money if the state doesn't want to participate in the expansion.

Although the court also announced state governments have the right to decide their financial support to the law according to their own financing situation, growing expenses incurred by the law will be a big burden to each local government, Xu said.

Sticking to the principle of "small government," most Republicans said the ACA violates U.S. citizens' freedom. Xu said, "What they oppose is not the plan of expanding healthcare coverage, but the compulsory way." Besides, he added, some of those who resisted don't even understand what the ACA is.

Future uncertainties

The law is declared to be constitutional, but it doesn't mean a victory for Obama, nor the law itself. Observers pointed out that the court's decision will sharpen political disputes between the two major parties in the United States.

Guo said the ACA will help Obama win more votes from the poor, because they will think the Democratic Party and its president are truly on their side. But the court's decision will not only widen the social gap between the poor and the rich, but also aggravate conflicts between the Democratic Party and the Republic Party.

Xu agreed that political incompatibility in the United States will increase. He added that the decision will definitely influence the country's upcoming presidential election. He said the presumptive Republican presidential candidate Mitt Romney has continuously attacked Obama on the ACA. Now Obama can take a breath, Xu said.

However, the Supreme Court stated that the fine is essentially a tax, which the government has the right to impose, making the result not a complete victory for Obama and the ACA. "If the future president and U.S. Congress decide to abolish the law, they can do it," Xu said.

According to the ACA, the law will be implemented from March 2010 to 2019. Xu said if Obama wins a second term, he can finish the whole process. But giant expenses will remain as a big task in his second term.

The result rang a bell to the Republicans. They cannot abolish the law through litigation. Xu predicted that this might encourage the Republicans to try their best to win the coming presidential election and the next mid-term elections, the only option for now.

(With reporting by Huang Wei in New York City)

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