Each time The Associated Press has asked in polls, more than 8 in 10 Americans have said the government should not have the right to require everyone to buy health insurance.
And the public has tilted against the law as a whole over the two years since it was passed. About half opposed it and a third were in favor in an AP-GfK poll shortly before the Supreme Court ruled.
Many elderly Americans are worried about the cuts in reimbursements paid to hospitals and insurers by Medicare, which have already started and will grow deeper.
Q: Does the insurance mandate affect many people?
A: Relatively few, because more than 8 in 10 Americans already have insurance coverage.
Employers face their own mandate. Those with 50 or more workers will be fined if they don't provide insurance for their employees, and opponents argue that will cost jobs at a time of high unemployment.
Q: Why impose a mandate that's unpopular and won't require any action by most people?
A: The mandate is designed to produce extra income from more healthy, paying customers so insurers can to hold down costs for everyone. Without the mandate, insurance companies probably would find it too expensive to comply with requirements to accept customers with pre-existing health problems and not charge them extra. Companies sought to control their costs by cherry-picking the healthy as their customers.
Q: Is the penalty for the uninsured a tax?
A: It will be collected along with income tax each year by the Internal Revenue Service.
But Obama and Democrats have avoided using the dreaded "t-word." Instead, they referred to it as a penalty for failing to act responsibly and focused publicly on other legal justifications. Before the Supreme Court, however, the Obama administration also argued that the law was constitutional under the federal government's power to levy taxes.
The court rejected the Obama administration's other two legal arguments for the law but accepted the tax one.
Still, most of the 20 million or more without insurance will not be docked. By 2016, about 4 million people will pay the penalty, the Congressional Budget Office has estimated. They would pay $695 for each uninsured adult or 2.5 percent of family income, up to $12,500 a year.
The IRS can't prosecute violators or place liens against them, however. Its only enforcement option may be withholding money from refunds.
Q: What other new taxes are in the law?
A: An assortment, including: Individuals making more than $200,000 a year and couples earning above $250,000 will get new payroll taxes. These people are also hit with a 3.8 percent tax on investment income. Medical-device makers will pay a 2.3 percent excise tax, which probably will get passed along to patients. Taxpayers will have to spend more on unreimbursed medical care before they can claim itemized deductions.
Q: What are Republicans saying?
"Obamacare was bad law yesterday. It's bad law today," Romney said.
Senate Republican leader Mitch McConnell said Obama deceived Americans by denying that the penalty on the uninsured amounts to a tax. The ruling marks "a fresh start on the road to repeal," he declared.
The Republican-led House already has voted for repeal — and its leaders plan to repeat that vote next month — but repeal is stuck there so long as Obama's in the White House and Democrats lead the Senate.
Q: What does Obama say?
A: He says the decision upholds the fundamental principle that in the wealthiest nation on earth, no one should be ruined financially by an illness or accident. Obama called it "a victory for people all over this country whose lives will be more secure because of this law."
Q: If the law survives in Congress, will the health care issue finally be put to rest?
A: No, there's more to do. Although the law is supposed to help curb costs, the nation's spending on health care already is enormous and sure to climb as the baby boom generation ages.
Reader Comments (