1- Roberts' decision strikes a serious blow against centralizing federal power in that he refused to let the law be judged constitutional on the basis of the "commerce clause." This clause has been incorrectly used (IMO) as a legel "gimmick" to justify federal government takeovers of functions of government and life not given it by the framers.
2- The provision in the decision that forbids federal government coercion of the states through denial of Medicaid funding if they do not comply with expansion of Medicaid is another such brake on federal power.
3- This law will fund medical care for the poor, mostly people of color, by requiring them to have health insurance paid for on a means tested basis through federal subsidies. Some of the money for the subidies for the recipients or their employers will come from fines (taxes) collected from those who do not voluntarily sign up for insurance. These fines will be insufficient to pay for the subsidies. Some of the money to pay for these will simply be "magic money" created by the federal government or borrowed abroad but a lot of it will come from the tax receipts of the federal government. Other funds will be found through decelerating the growth of Medicare (the middle class health care program). The probable recipients of the subsidies mostly do not presently pay any federal income tax.
4- The Middle Class not surprisingly sees this as a law that essentially transfers wealth from them to recipients of the coming subsidies to poor people for health car insurance. Many of those who think their ox is being gored already think that the probable recipients are free loaders in today's society. Their rage is unbounded. Underlying this rage is a strong sense of dispossession in society as a whole.
5- Hospitals and insurance companies ought to benefit tremendously from this largesse. Municipalities that maintain public hospitals will benefit financially.
What do I think of this" I applaud the push back against federal power in the judgment. I want to see health care for the poor even if they are not doing enough to get it for themselves. Personally I would be willing to pay higher taxes to provide healther care for the poor. BHO's minority supporters have complained bitterly that he has not done enough for them vis a vis the rest of us. Perhaps now they will see that he has. pl