Govs perplexed: The ruling creates a dilemma for states, which can now decide whether to participate in the law's expansion of Medicaid — a decision laden with political overtones for Republican governors who oppose the healthcare law. The court said that states can refuse to participate in Medicaid expansion, projected to provide coverage for millions of uninsured low-income people. Before, governors who did not expand their Medicaid rolls would have lost all federal dollars for the program. That approach was strongly criticized in the majority opinion from Chief Justice John Roberts.

"The financial 'inducement' Congress has chosen is much more than 'relatively mild encouragement' to expand Medicaid," Roberts wrote. "It is a gun to the head."

The law tried to make the expansion easier on states by sticking the federal government with the bill until 2016. House Minority Leader Nancy Pelosi (D-Calif.) noted this provision as she defended the Medicaid provision on Thursday.

"I don't think that's a gun to the head," she said. "We wrote this very carefully because we wanted it to be well received." She added that Democrats are not "bothered" by the court's ruling on the law's Medicaid portion because states still have an incentive to comply.

"We think that most governors would probably accept 100 percent funding without matching funds," she said.

Roberts re-examined: This was an important day for President Obama, and an equally important milestone for Chief Justice John Roberts. The healthcare ruling was sure to send shock waves through Washington no matter what, but Roberts’s role and the specifics of his reasoning were especially surprising to lawmakers and legal experts.

“I think it was tactically brilliant, whatever one thinks of the substance of the ruling,” said Kevin Walsh, a law professor at Richmond University and a former clerk to Justice Antonin Scalia.

The decision managed to avoid the biggest substantive fears of each side: Democrats didn’t see the court strike down a sitting president’s signature domestic achievement, and Republicans didn’t see an expansion of Congress’s power under the Commerce Clause.

Healthwatch has much more on the tactical side of Roberts’s ruling.

Obama’s elated: Basking in an enormous political triumph, President Obama on Thursday hailed the Supreme Court’s ruling on the healthcare law as “a victory for people all over this country.”

Speaking in the East Room a little more than two hours after the decision came down, Obama acknowledged talk about the decision will center on “who won and who lost,” but said that “completely misses the point." He said he pursued healthcare because he “believed it was good for the country.” The Hill has more on Obama’s elation.

Pelosi vindicated: House Minority Leader Nancy Pelosi (D-Calif.) turned out to be right: the Supreme Court did find the healthcare law is constitutional. Pelosi, along with many members of her party, had said repeatedly that the entire Affordable Care Act was “ironclad.” Had the decision not come down in the law's favor, the remark could have given her party the chance to hammer the court for trying to undermine President Obama ahead of November's election. But it didn't. Not one major Republican leader in Congress made a concrete prediction about what the court would do, according to a review by The Hill. More here.

Kennedy responsible?: House Minority Leader Nancy Pelosi on Thursday credited the late Sen. Edward Kennedy (D-Mass.) with driving the success of the Democrats' healthcare law – even from his grave. The California Democrat said Kennedy — who died of brain cancer in August 2009, months before the law passed — provided the inspiration for Democrats to continue fighting for the reforms.

"I knew that when he left us he would go to heaven and help pass the bill," Pelosi told reporters in the Capitol. "And now he can rest in peace. His dream for America's families has become a reality."

After the ruling was announced, Pelosi said she called Vicki Kennedy, the late senator's widow, as well as former-Rep. Patrick Kennedy (D-R.I.), his son, to thank them "for the important role that he played — a lifetime of commitment — to making healthcare a right, not a privilege, in our country." More here.

Republicans shocked: GOP lawmakers expressed shock and deep disappointment on Thursday. Sen. Mike Lee (R-Utah), a Tea Party favorite and member of the Judiciary Committee elected in 2010, said he was “shocked” Roberts found the law’s mandate that people buy insurance to be a tax.

“I disagree with it,” he said, adding that he was disappointed in Roberts.

Sen. Jeff Sessions (R-Ala.) said that while he did not regret voting for Roberts, he could not understand how the chief justice could reach his conclusion, particularly when the law’s authors argued it was not a tax during the congressional debate.

“This was sold as a mandate, they called it a mandate, it looked like a mandate and in oral argument [the solicitor general] came in and claimed it was a tax, but I’m not sure the chief was right in concluding it was a tax,” Sessions said. More here.

Boehner 'resolved': House Speaker John Boehner (R-Ohio) said the Supreme Court’s decision to uphold the majority of President Obama’s healthcare reform law would “strengthen [the] resolve” of the GOP to repeal it entirely. But he declined to criticize the Supreme Court or Chief Justice John Roberts, the George W. Bush appointee who provided the deciding vote in favor of the law.

“I’m blessed that I’m not a lawyer,” Boehner said. “It’s not for me to decide. While I’m disappointed in their decision, they came to a decision. I respect it.”

GOP leaders announced they would move forward with another House vote to fully repeal the law in July, despite the fact that the House has already held one repeal vote that was rejected by the Senate. More here.

Crowds berserk: A circus atmosphere outside the Supreme Court turned partisan Thursday after the decision was released. Opponents of the law gathered near the center of the steps and chanted "Strike it down!" as the clock ticked toward 10 a.m., when the court's session began. Some in the crowd had brought along a life-size mannequin of Jesus in a tan robe. Many waved the "Don't tread on me" flags associated with the Tea Party movement or held "Defund Planned Parenthood" banners.

Hours later, crowds thinned, leaving die-hards on both sides involved in heated arguments. In one case, a liberal woman and conservative man berated each other to such a degree that Supreme Court police were called to stand by in case of a tussle. "Healthcare access is about people's lives!" the woman cried, as the man kneeled in mock reverence before her. "What more free stuff do you want from the government?" he yelled back. "What else do you want?" More here.

Rahm jokes: Chicago Mayor Rahm Emanuel (D) joked that it's a good thing President Obama ignored his past advice not to pursue healthcare reform. Emanuel served under Obama from 2008 to 2010 as chief of staff and implored the president not to attempt something so monumental. He feared the "political cost" would be too much, he said.

“I told [Obama] up front ... If you’re doing this, you can’t do this, this and this," Emanuel told the Chicago Sun-Times. "I would like to take one minute to step back and acknowledge the type of courage it took. ... For 60 to 70 years, president after president of both parties tried to achieve what President Obama has achieved."

He went on to call Thursday's decision — and Chief Justice John Roberts's choice to side with the court's liberals — "rich with irony." More here

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