The U.S. Supreme Court will rule Thursday on the constitutionality of the sweeping health care law championed by President Barack Obama , in a hotly awaited decision that is bound to divide the country . The stakes can not be overstated : what the justices decide will have an immediate and long-term impact on all Americans , both in how they get medicine and health care , and also in vast , yet unknown areas of `` commerce . '' Five scenarios : Health care options before the justices . According to a poll released Tuesday , 37 % of Americans say they would be pleased if the health care law is deemed unconstitutional by the Supreme Court . Twenty-eight percent would be pleased if the Affordable Care Act is ruled constitutional , the NBC News/Wall Street Journal survey showed , compared to 35 % who said they would be disappointed if the court came back with that outcome . But nearly four in 10 Americans surveyed said they would have `` mixed feelings '' if the justices struck down the whole law . The survey of 1,000 adults was conducted June 20-24 . The real people behind health care reform . Previous surveys have indicated that some who oppose the law do so because they think it does n't go far enough . The polarizing law , dubbed `` Obamacare '' by many , is the signature legislation of Obama 's time in office . Mitt Romney , the presumptive Republican presidential nominee , told supporters in Virginia on Tuesday : `` If Obamacare is not deemed constitutional , then the first three and a half years of this president 's term will have been wasted on something that has not helped the American people . '' Romney , whose opposition to the law has been a rallying cry on the stump , continued : `` If it is deemed to stand , then I 'll tell you one thing . Then we 'll have to have a president -- and I 'm that one -- that 's gon na get rid of Obamacare . We 're gon na stop it on day one . '' Speaking to supporters in Atlanta Tuesday , Obama defended his health care law as the way forward for the American people . Opinion : Aging boomers need health care law . `` They understand we do n't need to re-fight this battle over health care , '' he said . `` It 's the right thing to do that we 've got 3 million young people who are on their parent 's health insurance plans that did n't have it before . It 's the right thing to do to give seniors discounts on their prescription drugs . It 's the right thing to do to give 30 million Americans health insurance that did n't have it before . '' White House spokesman Jay Carney told reporters Tuesday that the administration is `` confident that the Affordable Care Act is constitutional , in keeping with decades of precedent under the Commerce Clause . We continue to implement the law accordingly , and we are ready for the Supreme Court 's decision , whatever it may be . '' In its ruling Thursday , the nation 's highest court could rule the whole law constitutional or unconstitutional , or strike down certain portions of the law while letting other provisions stand . The Supreme Court heard three days of politically charged hearings in March on the 2010 Patient Protection and Affordable Care Act , a landmark but controversial measure passed by congressional Democrats despite pitched Republican opposition . The challenge focused primarily on the law 's requirement that most Americans buy health insurance or pay a fine . Supporters of the plan argued the `` individual mandate '' is necessary for the system to work , while critics argued it is an unconstitutional intrusion on individual freedom . All sides preparing for political fallout from health care decision . Four different federal appeals courts heard challenges to parts of the law before the Supreme Court ruling , and came up with three different results . Courts in Cincinnati and Washington voted to uphold the law , while the appeals court in Atlanta struck down the individual mandate . A fourth panel , in Richmond , Virginia , put its decision off until penalties for failing to buy health insurance take effect in 2014 . The Patient Protection and Affordable Care Act passed Congress along strictly partisan lines in March 2010 , after a lengthy and heated debate marked by intense opposition from the health insurance industry and conservative groups . When Obama signed the legislation later that month , he called it historic and said it marked a `` new season in America . '' While it was not the comprehensive national health care system liberals initially sought , supporters said the law would reduce health care costs , expand coverage and protect consumers . Health care 's big four issues : What the justices are tackling . The law establishes a staged series of reforms over several years , including banning insurance companies from denying coverage to people with pre-existing conditions , forbidding insurers from setting a dollar limit on health coverage payouts , and requiring them to cover preventative care at no additional cost to consumers . It also required individuals to have health insurance , either through their employers or a state-sponsored exchange , or face a fine beginning in 2014 . Supporters argue the individual mandate is critical to the success of the legislation , because it expands the pool of people paying for insurance and ensures that healthy people do not opt out of buying insurance until they needed it . Critics say the provision gives the government too much power over what they say should be a personal economic decision . Twenty-six states , led by Florida , say individuals can not be forced to buy insurance , a `` product '' they may neither want nor need . And they argue that if that provision is unconstitutional , the entire law must go . The Justice Department countered that since every American will need medical care at some point in their lives , individuals do not `` choose '' whether to participate in the health care market . Congress ready for high court 's health care decisions -- then it gets tricky . The partisan debate around such a sweeping piece of legislation has encompassed almost every traditional hot-button topic : abortion and contraception funding , state and individual rights , federal deficits , end-of-life care , and the overall economy . During arguments on March 27 , Justice Anthony Kennedy said the law appeared to `` change the relationship between the government and the individual in a profound way . '' Chief Justice John Roberts argued that `` all bets are off '' when it comes to federal government authority if Congress was found to have the authority to regulate health care in the name of commerce . Liberal justices , however , argued people who do n't pay into the health system by purchasing insurance make care more expensive for everyone . Timeline of the health care law . `` It is not your free choice '' to stay out of the market for life , Justice Ruth Bader Ginsburg said during arguments . `` I think the justices probably came into the argument with their minds made up . They had hundreds of briefs and months to study them , '' said Thomas Goldstein , publisher of SCOTUSblog.com and a prominent Washington attorney , though he conceded that `` the oral arguments ( in March ) might have changed their minds around the margin . '' The law , which helped spur the creation of the conservative tea party movement , is likely to be a centerpiece of the presidential election campaign . The legislation signed by Obama reached 2,700 pages , nine major sections and some 450 provisions . The first lawsuits challenging the health care overhaul began just hours after the president signed the measure . Basics : Health care reform issues .
The Supreme Court decision on health care will come Thursday . A federal appeals court in Washington ruled that the subsidies are illegal because Congress never appropriated money for them. The law requires individuals to buy health insurance or face a fine .