WASHINGTON (AP) -- The individual mandate survives.
The Supreme Court has upheld the heart of President Barack Obama's health care overhaul -- ruling in favor of the requirement that most Americans can be required to have health insurance, or else pay a penalty.
The decision means the historic overhaul will continue to take effect over the next several years, affecting the way countless Americans receive and pay for their personal medical care.
The court found problems with the law's expansion of Medicaid. But even there, it said the expansion could proceed as long as the federal government does not threaten to withhold the entire Medicaid allotment to states if they don't take part in the extension.
The court's four liberal justices, Stephen Bryer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.
Oklahoma Attorney General Scott Pruitt, who was in attendance for Thursday's decision, released a statement following the Supreme Court announcement.
"We're disappointed the court upheld the individual mandate, and find it disturbing that they did not place a limit on the power of the federal government to control the lives of Americans. But, the battle isn't over," he said. "It is now up to the political process to repeal the act and replace it with measures that address the health care crisis within the confines of the Constitution."
Oklahoma, which declined to set up a state-run health insurance exchange, now will have to create one to avoid being absorbed into the federal system — the very thing they're fiercely trying to avoid.
"I'm extremely disappointed and frustrated by the Supreme Court's decision to uphold the federal health care law," said Okla. Gov. Mary Fallin. "President Obama's health care policies will limit patients' health care choices, reduce the quality of health care in the United States and will cost the state of Oklahoma more than a half billion dollars in the process.
Fallin spokesman Alex Weintz said before the decision the governor had not decided how to proceed if the law were to be upheld, but would discuss options in the event.
The state of Oklahoma filed a federal individual lawsuit claiming the law to be unconstitutional in 2011. In 2010, nearly 65 percent of voters favored a constitutional amendment that would prohibit forced participation in a health care system.