Minnesota reaction: From experts to Main St.

Peter J. Nelson, policy fellow, Center for the American Experiment:

"The Supreme Court's decision to uphold the individual mandate represents a tremendously disappointing expansion of federal power over the lives and liberties of the American people. By upholding the individual mandate as a proper exercise of Congress's taxing power, it's hard to see what sphere of an individual's life is safe from congressional meddling.

"The Court's ruling says nothing about the wisdom of the health care overhaul. While the law took aim at real problems in need of real solutions, it took the wrong approach. When the law passed, nearly every credible expert admitted that it did nothing to solve the central problem with our health care system: the increasingly unaffordable cost to both families and the government. Rather, the law irresponsibly spends federal money American taxpayers simply can't afford."

Ken Paulus, president and CEO, Allina Health (owner of Abbott Northwestern, Mercy, Unity, United hospitals and more than 30 medical clinics):

"I believe [it] will be good for our country and in the long run will be less expensive than caring for individuals through current charity-care policies. We embraced the health care reform act as it rolled out. We decided it was our civic duty to get behind the law and make it work. We will continue to do that."

Elizabeth Frost, M.D., a physician at Hennepin County's East Lake Street Clinic and a local leader of Physicians for a National Health Plan:

"It's fantastic that the court has upheld the idea that health care is a common good - that everyone deserves it but at the same time should pay into it. If people think of it as tax, they'll be motivated to make sure their money gets well spent.

Mary Brainerd, President and CEO of HealthPartners:

"The Supreme Court decision to uphold the requirement that individuals have health insurance makes sense. Without that requirement, health care and health insurance would be less affordable for everyone because many wouldn't buy insurance until they were already ill or needed coverage.

"But adjustments in the law are still needed to make sure that coverage is affordable. In the current law, individuals and small employers will pay for more of the costs, and we are concerned about that. We also want individuals and families to have choices about the coverage that works best for their needs. Congressional action is needed to make important improvements to ensure affordability and choice."

Rep. Erik Paulsen, R-Minn., a member of the U.S. House Ways and Means Committee:

"While I respect the Court's decision, it doesn't change the fact that the health care law's policy is flawed and remains very unpopular with the majority of Americans.

"Americans deserve a government that works together towards meaningful health care reform. Unfortunately, today's ruling does not bring us closer to that goal, and only says that Americans must now face a choice between either paying a massive new tax or higher insurance premiums."

Kate Johansen, lobbyist for the Minnesota Chamber of Commerce:

"Not a lot of businesses were saying I'm going to ignore this [law] until there's a Supreme Court ruling. They've been working with this law for two years. Now they can move ahead, knowing the law is in place. They can do calculations, figure out subsidies and credits, and [decide]: Do they want to provide insurance? Can they afford it? How will they work with the exchange?"

Prof. Lawrence Jacobs, political scientist and health care scholar, University of Minnesota:

"Today's Supreme Court ruling makes health reform the law of the land and will start a stampede by Minnesota and other states to meet imminent deadlines to comply with the Affordable Care Act. The court's decision should remove the cloud of constitutional doubts that that has deterred the Republican-controlled Minnesota Legislature from working with the Dayton administration.

"The decision also lets stand the most comprehensive set of initiatives to date to control rising U.S. health care costs. For families facing higher bills, insurance companies are compelled to devote at least 80% of premiums to medical care and improvements -- and rebate to customers any excess they collected in premiums. Tougher fiscal oversight for Medicare will also help the federal government's bottom line. Businesses and other payers will benefit from new ways to pay health providers, because the Affordable Care Act encourages incentives for quality outcomes rather than payments for sheer volumes of procedures and services."

Lawrence Massa, president, Minnesota Hospital Association:

"The biggest reaction right now is a sense of relief that now we know this piece of the puzzle is in place. But I think everybody understands it's a work in progress, that we have an election coming up...

"Our members aren't saying they're going to do anything different tomorrow than they would have done if a different decision had been reached."

Dr. Patricia Lindholm, past president of the Minnesota Medical Association, and family physician in Fergus Falls:

"As a primary care doctor, it takes a lot of stress out of the relationship with the patient when they're saying: 'Can I skip my appointment because it costs such and such?' Or: 'I can't afford the medication.'

"If we can make it easier to participate in the health care system, our lives as providers would be a lot easier too."

Rep. Steve Gottwalt, R-St. Cloud, chairman of the state House Health and Human Services Finance Committee:

"Outside of the fact I believe the U.S. Supreme Court got it wrong on the huge issue of constitutionality, this decision makes the challenges before us much more difficult.

"The Affordable Care Act solves nothing in terms of delivering greater access to lower cost, higher quality health care. Having the federal government take over the direction of health care for our state takes Minnesota backwards. The added costs to Minnesotans are simply unsustainable, and the law makes a mess of Minnesota's nation-leading reform efforts."