The U.S. Supreme Court's ruling to uphold the Affordable Care Act appears to have taken activists – both liberal and conservative -- by surprise.
In the Portland area, today's ruling transformed a long-planned Pioneer Square rally from a protest into a celebration.
Meanwhile, Washington State Attorney General Rob McKenna – currently duking it out in a rough campaign for governor against former U.S. Rep. Jay Inslee, a Democrat – took one on the chin, as he was a key figure in the original legal challenge to President Barack Obama's health plan.
Activists with Washington CAN planned protests throughout the day Thursday at McKenna's office and across the state, arguing that McKenna "should be ashamed for a partisan lawsuit that jeopardized coverage for women, small businesses and people with pre-existing conditions.
"Local Washingtonians will share stories of how the ACA is benefiting their lives, and call on Rob McKenna to stop his partisan attacks against health care reform," the activists said in a statement.
Despite liberal lawmakers' calls for "less divisive rhetoric" moving forward after today's landmark court decision, conservatives appear to be gearing up for an even bigger post-"Obamacare" fight: defeating the President at the polls in November.
Here is a survey of reactions from around the Pacific Northwest region, and around the country:
Washington State Attorney General Rob McKenna
"Our system of government provides a series of checks and balances, allowing new laws—especially ones that raise major constitutional questions—to be tested in court.
"While we're disappointed that this close decision did not find in the states' favor with regard to the individual mandate, the country benefits from a thoughtful debate about the reach of federal power into the legal rights of the states and the personal financial decisions of all Americans.
Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use," the Court wrote. "What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.
"Now the federal government must treat the states as equal partners, as both seek to provide health coverage for the poor."
Jay Inslee, Democratic candidate for governor of Washington
"Today, in a majority ruling by Justices appointed by Presidents of both parties, the Supreme Court upheld the Affordable Care Act.
What this means for Washingtonians is that insurance companies can no longer deny people coverage based on pre-existing conditions; there can be no caps on lifetime coverage; young men and women just starting out on their career paths can stay on their parents' insurance until the age of 26; and prescription drugs will become more affordable with the closing of the so-called Medicare 'donut hole.'
"The Supreme Court upheld this law despite enormous political pressure by Republican Attorneys General from around the country who tried to make this a partisan, political issue.
"It is my hope that Republicans do not see today's ruling as an opportunity for further partisan bickering. Instead, we need both parties to finally come together and make this law work for the American people.
"Now, with this issue settled by the Supreme Court, let's all focus on the most pressing issue we face – getting our economy moving again by creating good-paying jobs for the middle-class."
Oregon Gov. John Kitzhaber
"I am pleased that the Supreme Court has upheld the Affordable Care Act, which will help all Oregonians, including the 600,000 Oregonians who are uninsured, have better access to health coverage. It's a vindication of the Obama Administration's bold approach. Oregon's health transformation initiative is well underway. We're moving forward with Coordinated Care Organizations that will transform Medicaid for better health and lower cost. And the Oregon Health Insurance Exchange will be a central marketplace where individuals and small businesses can shop for health plans and receive help paying for coverage."
Oregon Health and Sciences University President Dr. Joe Robertson, M.D., M.B.A.
"Today's ruling directly impacts OHSU in that we will need to increase the number of health care professionals we train in order to respond to the growing number of patients as a result of universal access. We look forward to working with the Governor, the Legislature and other parties in addressing this need.
"In regards to the hard work taking place in Oregon to reform health care, we are proud to be part of Oregon's efforts to reform health care and pleased those efforts continue to move full speed. Governor Kitzhaber's innovative plan for reform is being implemented at this moment, built around the establishment of new Coordinated Care Organizations. The $1.9 billion agreement with the Obama Administration, an investment in the Governor's plan (known as Transformation), is still on track.
"We expect the eyes of the nation will be on Oregon to see if transformation can improve everyone's health while reducing costs. There is hard work ahead, but we believe Oregon is up to the job."
U.S. Rep. Adam Smith (D-WA)
"I'm pleased the Supreme Court has upheld the Patient Care and Affordable Health Care Act. This law is the best available step forward for our health care system that is in dire need of reform.
"The Affordable Care Act will help nearly 30 million uninsured Americans obtain health insurance and will cut our deficit by more than $1 trillion in the long-term with mechanisms in place to curb fraudulent and wasteful medical spending. It gives Americans the promise of better care by keeping health care and insurance providers accountable for the well being of their patients. The law has also established free preventative care and has empowered states to create new and more efficient methods to deliver the highest quality options for health care."
John Kuzmanich, chair, Oregon Tea Party PAC
"I'm stunned that the individual mandate was upheld. Apparently Justice Roberts' opinion places limits on the expansion of the Federal Government under the Commerce Clause, but I don't believe most Americans will be satisfied knowing that they can now be forced to buy a product from a private company against their wishes. When the Nancy Pelosi / Harry Reid Congress passed this bill, it was sold as a lie. Despite their claims, this is a huge tax on businesses and the middle class. As we've said all along, this is a massive tax increase that the American people overwhelmingly oppose, during the worst economic downturn of our lives. One thing is certain – this ruling has motivated our grass roots volunteers like nothing we've seen. We're already hearing from our volunteers that they are motivated like never before."
Bruce Goldberg, M.D., Oregon Health Authority director
"The Supreme Court ruling today upholding the Affordable Care Act is very good news for the 600,000 Oregonians who do not have health care coverage.
"Because of the cost, health care had become out of reach for too many people. It has been particularly difficult for low-income Oregonians to get health care coverage. We have a limited number of openings for adults on the Oregon Health Plan and we draw names to fill them. It's like a health care lottery.
"Today's decision will make it possible for an estimated 180,000 to 200,000 more people to qualify for the Oregon Health Plan in 2014. Hundreds of thousands more people will have access to the health insurance exchange.
"Under the Affordable Care Act, the health care lottery for low-income Oregonians goes away and everyone wins.
"That is good for them, good for their families, and good for the Oregon. They will have better health care and more financial security.
"Key to making it work is making health care more affordable. In Oregon we have already started remaking our health care system to be more efficient, effective and patient-centered. Eight new Coordinated Care Organizations will begin serving Oregon Health Plan clients on August 1 and more will be starting throughout the year. Our local communities are coming together in unprecedented ways to improve care.
"We truly are on a path, both locally and nationally, to make our health care system something that brings better health and better care at a more affordable cost."
King County (WA) Councilmember Larry Phillips
"The health of King County residents and that of King County's economy and will be better off with the United States Supreme Court's ruling today to uphold the Affordable Care Act. The dream, and now the reality, of healthcare for all is within reach after decades of struggling in vain to reduce the number of uninsured residents in our county and state.
"With implementation of the Affordable Care Act, we will be able to increase the health and stability of King County families as well as that of small businesses, and reduce the amount of charity care shifted to hospitals and local governments like King County. This is a great and historic day for King County and all Americans."
Jan Meekcoms, Oregon state director for the National Federation of Independent Business which was the named plaintiff in today's landmark decision in NFIB v. Sebelius
"While very disappointed, we respect today's SCOTUS decision to uphold the individual mandate. This decision creates tax increases and mandates that stand in the way of job creation and make high health-care costs an impediment to growing Oregon's economy. We feel the PPACA is the wrong path and the wrong direction for true health care reform. We will continue to fight for our members in the regulatory and legislative arenas."
Cynthia Pappas, CEO of Planned Parenthood of Southwestern Oregon
"At Planned Parenthood, we know how important this law and this decision are for women and families, because we see the need for affordable health care every day. Women who come into Planned Parenthood health centers often struggle to balance paying for birth control and health services with paying for groceries or gas for the car. The Affordable Care Act will make those decisions easier for women across the country."
Jeana Frazzini, Executive Director of Basic Rights Oregon.
"This ruling will mean that thousands of lesbian, gay, bisexual and transgender Oregonians will have access to critical health care and will not be forced to access more costly forms of care such as emergency room visits. This is hugely important for people who identify as transgender or those with HIV or AIDS, who are routinely denied coverage."
Oregon Center for Public Policy analyst Janet Bauer
"The Supreme Court decision is a victory for all Oregonians. Oregon can continue to move forward with confidence with its plans to reach 440,000 uninsured Oregonians mainly through the Oregon Health Plan and a new health insurance exchange for individuals and small businesses.
The Affordable Care Act is a promise to Americans and Oregonians that we're all in this together. After today's ruling, we remain together."
Steve Buckstein, founder and senior policy analyst at Cascade Policy Institute
"The U.S. Supreme Court's ruling that most of the Patient Protection and Affordable Care Act (ObamaCare) is constitutional means that Congress now has power to do virtually whatever it wants. But having the power to write health care rules and actually improving our health care system are two very different things."
"By finding that the individual mandate cannot stand under the Commerce Clause, but can stand when looked at as a tax, the Court essentially seems to be telling Americans that while Congress cannot control every aspect of our behavior, it has virtually unlimited powers to tax us and spend the money as it sees fit."
Sen. Jeff Merkley, D-OR
"Today's decision creates a clear path forward. We must now focus on how to best deliver affordable, high-quality health care for every American.
"In 2009, Congress set out to fix our broken health care system because the status quo was unacceptable. We took on this problem because America could not afford a health system that rationed care depending on wealth, gave insurance company bureaucrats final say over life and death decisions, and weighed down our economic competitiveness like an anchor.
"After a year of debate, the Patient Protection and Affordable Care Act was passed by both Houses of Congress and signed by the President. This bill, while imperfect, made five major improvements to our current health care system.
-- Preventive Care – The bill greatly expanded access to preventive care, adding 15 million people that previously did not have health insurance to Medicaid, ending the "donut hole" that left many seniors unable to afford medications, and providing grants to build or expand health care clinics across the country.
-- Workforce – To meet the needs of the newly insured, as well as to replace the retiring baby boomers in crucial medical fields, such as primary care and nursing, the bill expanded training programs for health professionals.
-- Marketplaces – The bill created one-stop shops so families and small businesses can compare plans and prices to find the best heath care fit for themselves and join together to get better deals.
-- Small Business – The bill sent checks to small businesses to make it more affordable to offer health insurance for their workers.
-- Health Care Bill of Rights – The bill ensured that as a health care consumer, you had certain rights – that no insurance company can deny you coverage because of a pre-existing condition, that kids up to age 26 are able to stay on their parents' insurance policies, that women won't be charged more than men, that policies won't cut you off with arbitrary lifetime limits, and that insurance companies can't kick you off your policy when you get sick!"
Sen. Patty Murray, D-WA
"This is a victory for the health care security and stability of Washington families. Today's ruling means that families and small business owners will continue to benefit from better access, more choices, and a health care system that no longer works only for those who can afford it. It means that health care decisions will be in the hands of patients and their doctors, and that insurance companies will be forced to compete for the business of Washington state families.
"It is also welcome news for all those across our state who are already benefitting from this law. It means that over 62,000 young adults in Washington will be allowed to keep their health coverage, that tens of thousands of Washington seniors will continue to receive checks for Medicare support, that hundreds of thousands of patients will continue to access free preventative services like mammograms and colonoscopies, and that millions of policy holders will continue to see the value of their premium dollar improve.
"This decision offers a chance for those on all sides in this long and impassioned debate to begin the process of moving forward. It is time for us to come together to find common ground. As this bill continues to be implemented, there is no reason why we can't all work together to fix what's not working and take advantage of what is.
U.S. Rep. Suzanne Bonamici (D-OR)
"Today the Supreme Court rightly upheld the Affordable Care Act. Since 2010, the ACA has provided Americans with better health care coverage and lower costs. Thanks to the law, 17 million children across the country with preexisting conditions are no longer denied coverage, and 6.6 million young adults have been able to stay on their parents' insurance plans until they turn 26 years old. "In Oregon, more than one million people have received low-cost preventive care. These critical checkups diagnose illnesses early, keep Oregonians healthy, and ultimately make our health care system more efficient. In just two years millions of Americans have already seen tangible positive impacts from the legislation. The people of Oregon and across the country will benefit because the Supreme Court upheld these needed reforms to our health care system."
Health Care for America Now, Washington State
"Today, the Supreme Court ruled that the Affordable Care Act is here to stay.
The Affordable Care Act expands coverage to more than 30 million people and eliminates the worst insurance company abuses. It stops insurance companies from denying people care and jacking up rates whenever they please.
"As a result of this landmark decision, 100,000 women in Washington will have access to life-saving cervical and breast cancer screenings. More than 2.4 million Washingtonians no longer face lifetime caps on their health benefits. More than 1.2 million Washingtonians now have coverage for preventive care with no co-pays or deductibles. More than 60,000 Washington seniors in Medicare will continue to save hundreds on their prescription drugs. 52,000 young adults under 26 now have insurance on their parents' plans.
"Thousands of Washington small businesses can count on tax credits worth up to 35 percent of their health care costs, increasing to up to 50 percent in 2014. The Washington Health Benefits Exchange will give small businesses and consumers a marketplace with greater bargaining power and better choices."
David Rosenfeld, Oregon State Public Interest Research Group executive director
"Today's decision is good news for consumers in Oregon. Young adults can stay on their parent's plans until age 26. Insurance companies will have to keep spending at least 80% of premium dollars on care. They can't go back to the days of denying coverage to sick children. And in 2014, the days of insurers being able to deny anyone coverage for "pre-existing conditions" will be history.
"Now it's time for Oregon leaders to move forward on the next steps, and make sure health reform delivers lower costs and better quality coverage."
Richard A. Viguerie, chairman of ConservativeHQ.com
"The 2010 Tea Party wave election was all about the repeal of Obamacare and the individual mandate. If millions of Americans were enraged by the passage of Obamacare before the Supreme Court decision upholding the individual mandate was announced, their outrage will reach revolutionary fervor now that the mandate has been upheld.
"Conservatives believe with every fiber of our being that the plain language of the Constitution and our other founding documents, to say nothing of American history, demanded that the Supreme Court strike down Obamacare as unconstitutional.
"Today, a 5-4 majority of the Supreme Court of the United States--the body the Framers of the Constitution created to protect the citizenry from tyranny--has chosen to join infamous courts of the past, such as the Taney Court that made the Dred Scott v. Sandford decision finding that slaves had no rights and the Fuller Court that ruled to institutionalize Jim Crow discrimination in Plessy v. Ferguson in stripping Americans of their freedom.
"Those infamous decisions were eventually reversed, as this one should be.
"The Supreme Court's decision is a stark reminder that one presidential appointment to the Supreme Court is all that stood between our freedom and the tyranny that will grow ever greater now that the individual mandate has been upheld.
"If there was any reminder needed of what is at stake in this presidential election, the fractured vote upholding the mandate is it.
"There are now 130 days until Election Day. The Supreme Court has spoken, and the real work of protecting America from tyranny is now in the hands of Mitt Romney and the Republican Party."
Project 21 spokeswoman Dr. Elaina George
"By upholding ObamaCare, the Supreme Court ignored the Constitution. It placed corporate interests and profits, along with government control, above the needs of doctors and patients. This decision virtually guarantees the destruction of the doctor-patient relationship, and -- along with it -- individualized health care, innovation and access while it perpetuates the worst aspects of our medical system.
"Because of the mandate, Americans will be forced to pay for a system that will increase costs for patients, remove health care decisions from both the doctor and the patient and lead to rationing. It changes health care as we know it into a system based on one-size-fits-all, cost-controlled and conveyor belt socialized medicine."
Mat Staver, Founder and President of Liberty Counsel and Dean of Liberty University School of Law
"This is a stunning decision to uphold ObamaCare as a tax. Congress relied upon the Commerce Clause, not the Taxing and Spending Clause. The Court ignored the intent of Congress, which did not intend the mandate to be a tax but rather a penalty. Rulings like this on ObamaCare undermine the confidence of the people in the competency of the Supreme Court to follow the rule of law. Today's decision damages the image of the Supreme Court and is bad for America.
"ObamaCare is the largest funding of abortion in history. It will bankrupt America. It will destroy our healthcare system. The law must now be repealed."