LAST week, in a momentous decision, the United States Supreme Court upheld the 2010 Affordable Care Act and its most controversial provision known as the individual mandate, which requires most Americans to buy health insurance or pay a penalty. The Supreme Court held that the mandate was constitutional under the taxing authority afforded the federal government.

This landmark decision essentially rules that medical care is a privilege, not a right, and the privilege of American health care comes at a price to be determined by health insurance companies and the government. President Obama observed that the overriding principle is that people who can afford health insurance should take the responsibility to buy health insurance.

One of the key benefits of the Affordable Care Act is it could trigger lower health insurance costs for everyone – individuals and small businesses alike. By requiring most Americans to have health insurance, the pool of insured healthy people would expand – making the overall pool less risky.

Guam Delegate Madeleine Bordallo declared the decision "a victory for all Americans." And she stated the legislation was created to "expand coverage and reduce the cost of insurance for more Americans and protect them against insurance company abuses."

The law often described as Obamacare takes full effect in 2014 and is the largest expansion of the nation's social safety net in more than four decades. Obamacare means Americans will not be denied care or charged more due to a pre-existing condition, like cancer or asthma. Insurance companies will have to sell coverage to everyone, regardless of their medical history, and will have to restrict how much they vary premiums based on age.

A major change in the new law will be that annual health insurance limits will be eliminated. Before healthcare reform, health insurance companies on Guam were selling medical policies that would only pay up to $200,000 annually for off-island care. Somehow, Guam health insurers were able to sell policies that had a lifetime limit for coverage within Guam of only $1 million. Despite the fact that people on Guam were paying as much as U.S. mainland counterparts, Guam health insurers were able to sell policies that valued your child’s lifetime medical worth at these ridiculously low prices. No thanks to our incumbent senators in the Guam Legislature, by 2014, Guam insurers will no longer be able to place such disrespectful limits on medical coverage.

Obamacare significantly regulates the amount of profit that health insurers can take from patients. Insurance companies are now required to spend 80 to 85 percent of their premiums on insurance claims, depending on the size of the group covered. As a result of the new law, the government of Guam and many of our island’s people will be receiving $15 million in rebates from local healthcare companies by Aug. 1. This wonderful windfall is the result of the fact that most of Guam’s unregulated health insurers have been making obscene profits despite not paying any local taxes over the past many years.

The American Medical Association joined many of Guam’s physicians in celebrating the Supreme Court’s vindication of Obamacare. "Today's a great day for our nation's patients," AMA president-elect Ardis Hoven said. "It's an equally good day for physicians," who can expect an uptick in patients and fewer hassles in sorting out who will finance care,” Dr. Hoven said.