So, here’s what it means.  No healthcare chaos for starters, because the one thing everyone agreed on was that if only a portion of the bill was ruled unconstitutional it would have resulted in nothing short of a real mess.  So there’s some good news. 

It also means that the $1.1 billion in refunds due some consumers will stay in effect.  The law requires insurance companies to spend at least 80% of their premiums on healthcare and if not, they must refund a portion to their insureds.

The individual mandate remains in place which means that Americans must have health insurance by Jan. 1, 2014.  It turns out that chief Justice John Roberts was the deciding judge.  He wrote the majority opinion (5-4) and determined that the financial penalty for not buying health insurance was indeed a tax.

The fines for not having coverage therefore will remain in place.  In 2014 there will be $285 fine or 1% of income, whichever is greater.  At 2016, the fine increases to $2,085 or 2.5% of income.

The health care exchanges that each state is required to set-up stay.  The exchanges are designed to provide affordable coverage for those that need it.

So far the bill has helped about 2.5 million adults ( aged 18 to 26 to gain coverage by requiring that insurance companies provide coverage to children of the parents they insure.

The law will also require (in 2014) that insurance be provided to people with pre-existing conditions.  Companies can no longer “exclude, limit or set unrealistic rates on coverage.”
The Kaiser Family Foundation estimates that this provision affects one in five people who apply for health insurance.

Small businesses with more than 50 full-time employees will have to provide insurance coverage or face heavy fines.

The law has other smaller impacts which remain in place.  For example, Doctors must disclose the freebies that they get from suppliers including drug companies; and chain restaurants must disclose the calorie information for each menu item.

The individual mandate was considered a key part of the bill and was indeed the most contentious.  It was important  to the overall bill because it is usually the young and healthy that skip health insurance, and like all insurance, you need the “good” to help pay for those with higher risk.