"I strongly disagree with today's decision by the Supreme Court, but I am not surprised. The court has a dismal record when it comes to protecting liberty against unconstitutional excesses by Congress."

U.S. Rep. Ron Paul, R-Lake Jackson

"This morning's decision by the United States Supreme Court has clarified some things. It has made other things more muddled. What it has clarified is the importance of the upcoming election on Nov. 6, 2012. The only way to stop the overreaching by the federal government, including the president's flawed health care bill, is to elect a new president and a Congress that will repeal and replace this fundamentally flawed law."

U.S. Sen. John Cornyn, R-Texas

"I am extremely pleased that the Supreme Court has decisively ruled that the Affordable Care Act is constitutional. This is a huge victory for the American people and a testament to the hard work by the Obama administration and those in Congress who worked so hard to pass the law. The fight is not over, and I will continue to work to ensure that everyone in America has access to affordable and comprehensive health care. As more provisions of the act go into effect over the next few years, American families will see more benefits and have greater access."

U.S. Rep. Ruben Hinojosa, D-Mercedes

"I was certainly disappointed, this is the first time in America's history that the government has forced its citizens to purchase something. My big concern is that the primary role of government is to protect freedom. What this does is micro-manage the lives of citizens."

Michael Cloud, Victoria Republican Party chairman

"I think the Supreme Court of the United States upholding the Affordable Care Act is great. It's great to know that individuals up to age 26 can stay on their parents' health care until they're settled and have jobs, that insurance companies can't discriminate against someone with a pre-existing condition, and that under ObamaCare we will get to have preventative healthcare at little to cost. My focus now is trying to push our legislature to move forward and implement the law and start creating health care exchanges so that millions of uninsured Texans can start receiving health care."

Kelli Gill, Democratic Party chairwoman

Dr. Sanjeev Bhatia, of Victoria, has no doubt - every American deserves the right to affordable health care.

But even the Supreme Court of the United States' landmark decision to uphold the Patient Protection and Affordable Care Act on Thursday had him scratching his head.

"There are some pluses and some minuses," said the internist at Crossroads Health Center on Laurent Street.

Some Crossroads area doctors and leaders seem to be in agreement - the idea is right, but transforming an idea into reality is sketchy.

Doctors, such as Bhatia and Dr. Stephen Hougen, a Victoria general surgeon, foresee concerns that will impact local clinics, specialist offices and hospitals.

Bhatia's biggest worry revolves around a significant increase in patient load, but not much of an increase in doctors being able to handle that load.

About 14,610 people in Victoria were uninsured in 2010, according to the Texas Medical Association report. The uninsured tend to be younger adults, people in poor health and families with income below 200 percent of the poverty level.

These are the people we will see flooding our area clinics and hospitals, they said.

"You'll need to have more providers," he said. "There will be a need for more doctors and more mid-level practitioners."

Hougen also feels no one should go without. Still, the two share the same concern.

"My main concern is that providing universal health insurance is not tantamount to receiving health care," Hougen said.

Already, patients see delays with insurance companies, so having more people flood into the system could cause longer waits, he said.

However, it's still premature to know exactly how everything will play out.

"Health care is too darn expensive," Hougen said. "You've got to credit Obama for trying."

The passage of the health care overhaul means great things for future graduates of the University of Houston-Victoria's school of nursing, said Kathyrn Tart, the program's founding dean.

"As a nurse, I want people to experience good health," she said. "That's critically important."

Already, the need for nurses is high, and that need will grow as more people gain access to health care, she said.

Graduates are ready to lead the charge and are taught to nurse people through promoting healthier lifestyle, as opposed to viewing health care as a commodity.

UHV graduates are ready to help with this shift in thinking, she said.

"It's going to be confusing in the beginning, but as time progresses, it will all fall into place."

Doctors who deal first-hand with patients aren't the only ones worried, even some of the area's leaders have their reservations.

"It's been upheld, so we have to deal with it," said Judge Don Pozzi, after learning of the early morning decision.

For Pozzi, there are portions of the 2,000-plus page act that he agrees with and portions he disagrees with. Yet, his biggest issue is the government's power to run every person's life, he said.

"I do not agree with it in its entirety," Pozzi said. "It is government interference in our private lives."

Pozzi remains confused of how the act will work once enacted in 2014.

Even media outlets CNN and Fox News jumped the gun and sparked confusion, announcing that the centerpiece mandate had been ruled unconstitutional. Minutes later, the outlets clarified that the act was constitutional under the taxing clause, but not under the commerce clause.

Confusion and loopholes like this have Pozzi wary of the measure.

"The ruling is very suspect," he said.

The landmark decision is good news, said William Blanchard, chief executing officer for DeTar Healthcare Systems.

Blanchard commended the justices' decision to make health care accessible to millions of uninsured Americans.

"We look forward to providing essential health services for more members of our community as coverage expands," Blanchard said.

He sees a brighter future for hospitals as well as patients because of the overhaul. DeTar provides emergency care regardless of ability to pay, he said.

The passage of this act will only ensure more people receiving these services and proper reimbursement to the hospitals for the services provided, he continued.

The measure also affects the mental health sector, said Don Polzin, Gulf Bend Center's executive director.

Polzin had hoped for the bill's passage all along.

"I don't want to see it repealed," Polzin said a day before the court's decision. Polzin was not available Thursday. "I think it's important. I support the intent of that legislation."

Mental health services could use the boost, he said, and a measure like this will only ensure those with mental illness receive the services they need.

Right now, about 50 percent of Gulf Bend's clients have no health coverage.

Even if the act hadn't passed, the mission to merge mental and primary health care would be of utmost importance.

Still, Polzin remains a realist about its passage.

"I know resources and finances are finite," he said.

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Copy Desk Chief

J.R. Ortega is the copy desk chief for the Victoria Advocate. He also writes about gaming news. Follow him on Twitter, @gmrs_thmb.

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