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SCOTUS Upholds Key Provisions of Obamacare

(CNN) – In a landmark decision that will impact the nation for decades, the Supreme Court on Thursday upheld a key provision of President Barack Obama's health care law, ruling that requiring most people to have health insurance violates the Constitution.

The Affordable Care Act was passed in March 2010.

Here are some highlights:

The uninsured

The decision leaves in place the so-called individual mandate -- the requirement on Americans to have or buy health insurance beginning in 2014 or face a penalty -- although many are exempt from that provision.

In 2014, the penalty will be $285 per family or 1% of income, whichever is greater. By 2016, it goes up to $2,085 per family or 2.5% of income.

Health care exchanges, which are designed to offer cheaper health care plans, remain in place as well.

The insured

Because the requirement remains for people to have or buy insurance, the revenue stream designed to help pay for the law remains in place. So insured Americans may be avoiding a spike in premiums that could have resulted if the high court had tossed out the individual mandate but left other requirements on insurers in place.

Young adults

Millions of young adults up to age 26 who have gained health insurance due to the law will be able to keep it. The law requires insurers to cover the children of those they insure up to age 26. About 2.5 million young adults from age 19 to 25 obtained health coverage as a result of the Affordable Care Act, according to the U.S. Department of Health and Human Services.

Two of the nation's largest insurers, United Healthcare and Humana, recently announced they would voluntarily maintain some aspects of health care reform, including coverage of adult dependents up to age 26, even if the law was scrapped.

People with pre-existing conditions

Since the law remains in place, the requirement that insurers cover people with pre-existing medical conditions remains active.

The law also established that children under the age of 19 could no longer have limited benefits or be denied benefits because they had a pre-existing condition.

Starting in 2014, the law makes it illegal for any health insurance plan to use pre-existing conditions to exclude, limit or set unrealistic rates on coverage.

It also established national high-risk pools that people with such conditions could join sooner to get health insurance. As of April, a total of only about 67,000 people were enrolled in federally-funded pools established by the health care law, according to the National Conference of State Legislatures.

More than 13 million American non-elderly adults have been denied insurance specifically because of their medical conditions, according to the Commonwealth Fund. The Kaiser Family Foundation says 21% of people who apply for health insurance on their own get turned down, are charged a higher price, or offered a plan that excludes coverage for their pre-existing condition.

All taxpayers

No matter what the Supreme Court had decided, it would have been a mixed bag for all Americans when it comes to federal spending. There is heated dispute over what impact the health care law will have on the country over the long term.

The federal government is set to spend more than $1 trillion over the next decade to subsidize coverage and expand eligibility for Medicaid. The nonpartisan Congressional Budget Office estimated that the law could reduce deficits modestly in the first 10 years and then much more significantly in the second decade.

The CBO said a repeal of the mandate could reduce deficits by $282 billion over 10 years, because the government would be subsidizing insurance for fewer people. But the nation faces costs in various ways for having people who are uninsured. The Urban Institute's Health Policy Center estimated that without a mandate, 40 million Americans would remain uninsured.

Meanwhile, the Flexible Spending Accounts that millions of Americans use to save money tax-free for medical expenses will be sliced under the law. FSAs often allow people to put aside up to $5,000 pre-tax; as of 2013, they were to face an annual limit of $2,500.

Small business owners

The rules and benefits small business owners face as a result of the health care law remain in place.

As CNN has chronicled, the law brought a mix of both. The director of the National Federation of Independent Business is one of the plaintiffs who pushed the court to strike down the law. Meanwhile, a group called Small Business Majority fought to protect the law, saying its loss could be a nightmare.

As of 2014, under the law, small firms with more than 50 full-time employees would have to provide coverage or face expensive fines.

All Americans, in lesser known ways

The massive health care law requires doctors to report goodies they get from medical supply companies; demands more breastfeeding rooms; requires all chain restaurants to list calories under every menu item, and includes numerous other provisions, which now remain in place.

Doctors and other health care providers

Health care providers have already begun making changes based on the 2010 law, and in preparation for what will go into effect in 2014. Those plans continue.

In the short term, doctors avoid "chaos" that may have resulted from the law suddenly being dropped or changed, according to Bob Doherty, senior vice president of governmental affairs at the American College of Physicians, who wrote a blog post on the website kevinmd.com this spring.

Medical groups have disagreed over the law.

Here's a look at key moments in the law's history:

February 24, 2009 -- In a joint session to Congress, President Obama says: "So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year."

March 5, 2009 -- The Obama White House holds its first health care summit.

April 21, 2009 -- Senate Finance Committee Chairman Max Baucus and Ranking Member Chuck Grassley hold the first of three roundtables of health policy and industry experts to discuss the development of health care legislation.

July 15, 2009 -- The Senate's Health, Education, Labor and Pensions Committee passes The Affordable Health Choices Act. The bipartisan bill includes more than 160 Republican amendments accepted during the month-long mark-up, one of the longest in congressional history.

July 31, 2009 -- The bill is reported out of the House Committee on Energy and Commerce by a vote of 31 to 28.

August 15, 2009 -- During the August recess, Obama travels in support of the bill. Tea Party members and conservatives lash out against the bill at town halls. Obama battles a false rumor that the legislation includes "death panels" that could decide whether people live or die.

August 26, 2009 -- Sen. Edward "Ted" Kennedy, a leading proponent of health care legislation, dies, jeopardizing Senate Democrats' 60-seat filibuster-proof supermajority.

September 29, 2009 -- The Senate Finance Committee rejects two amendments to include a government-run public health insurance option in the sole compromise health care bill to date.

October 13, 2009 -- The Senate Finance Committee approves Baucus' landmark bill, the America's Healthy Future Act.

November 7, 2009 -- The House of Representatives passes a version of the sweeping health care bill by a vote of 220-215.

December 19, 2009 -- Senator Ben Nelson, a conservative Democrat, becomes the 60th vote needed to pass the Senate version of the health care bill.

December 24, 2009 -- The Senate passes its health care bill 60-39.

January 17, 2010 -- Obama stumps for Martha Coakley in a tight Massachusetts Senate race against Scott Brown to replace Kennedy. Brown had pledged to vote against Democratic health care efforts.

January 19, 2010 -- Brown wins the special election, jeopardizing the health care legislation.

February 25, 2010 -- Obama holds a televised heath care summit with leaders from both parties to explain the health care bill.

March 11, 2010 -- In a letter to Senate Minority Leader Mitch McConnell, Majority Leader Harry Reid says Democrats will use "reconciliation," needing only 51 votes, to pass the health care bill.

March 21, 2010 -- The Senate passes its version of the bill, sending the legislation to Obama for his signature. A separate package of changes expanding the reach of the measure also passed the House over unanimous GOP opposition, and will be taken up by the Senate.

March 23, 2010 -- Obama signs the health care bill into law.

August 12, 2011 -- The 11th Circuit Court of Appeals rules that parts of the law are unconstitutional.

November 8, 2011 -- The U.S. Court of Appeals in Washington rules that the law is constitutional.

November 14, 2011 -- The Supreme Court agrees to hear a legal challenge to the law after 26 states, led by Florida, petitioned the high court.

March 26, 2012 -- The Supreme Court begins three days of oral arguments over the constitutionality of the law.

June 28, 2012 -- The Supreme Court rules that the individual mandate portion of the health care law may be upheld within Congress' power under the taxing clause