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Like the divided Supreme Court that upheld President Barack Obama's federal health insurance overhaul, opinions in South Jersey on the issue were also split.

Outside of AtlantiCare's Urgent Care center, Manika Das, 29, said she supported the decision.

"I think everyone should have health care coverage," said Das, of Atlantic City, leaving the center after getting a prenatal checkup for her second child. She added, "And the government should help all the people who cannot afford health care."

Andrew Stasiowski, 69, exhaled loudly when told of the Supreme Court's decision a few minutes later, then added, "Oh, my God."

Stasiowski, of Leesburg, Fla., said, "I think the Democrats have gone in more of a communistic direction. People don't have the choices they want."

The 5-4 ruling Thursday morning upheld a central tenet of the 2010 Affordable Care Act, ruling that people can be penalized for not having health care. Writing for the majority, Chief Justice John Roberts said the penalty was tantamount to a tax, which Congress has the power to enact.

Stasiowski criticized the law because he said he believes it will require his tax dollars be spent on health care for illegal immigrants who may be terrorists. After visiting his son and newborn grandson, he said he'd paid for health care coverage and that all people should have coverage -- but not at his expense.

A few minutes after he left, Bonnie Johnson and her children walked to their van.

Johnson, 46, said she generally supported the law, but she was uncertain what she thought about the ruling. She had tried to listen to the radio commentators discuss the decision as she drove the boys to the clinic for blood work, accompanied by her other 5-year-old son and a niece. She could not make up her mind.

One of her twin 10-year-old boys has autism, so Johnson followed the court case because she wondered what the future would hold for him.

"That's more of a concern for their future more than for my future," Johnson said.

Inside AtlantiCare itself, doctors and administrators said the ruling justified some of the decisions that the company has made as it has sought to change the way it provides medical care.

The ruling is important, said AtlantiCare President and CEO David Tilton, because those who have health care have better access to care and that generally improves the overall health of the community.

It was also important because the health care organization, which employees more than 5,400 people and 600 doctors in more than 60 locations, has in recent years begun moving away from the historical fee-for-service model to one where all the providers have incentives for patient wellness and can provide coordinated care.

"This is the Supreme Court decision we were hoping for," Tilton said. "It clears the path for us to move forward with this new model."

Dr. Mitchell Kaminski felt "relieved and happy" by the decision. "What I take away from this is the Affordable Care Act has given us a blueprint," he said. "It is, at least, a coordinated program in fixing our health care system."

Kaminski, AtlantiCare's medical director for primary care and medical specialties, added, "It's just huge for all people to have that reassurance that they won't go without medical care."

"What's exciting is we won't have ... about a half-million people without insurance in New Jersey," Kaminski added, saying treatment of the uninsured is difficult and costly.

These uninsured patients tend to not make appointments, avoid recommended testing and skip medication to treat chronic conditions, Kaminski said. They tend to arrive in emergency rooms with no medical records and in poor health -- and are treated at greater cost.

Daniel J. Douglas, the director of the William J. Hughes Center for Public Policy at the Richard Stockton College of New Jersey, said that the ruling would bring the health care issue to the fore of the national debate.

The decision, he said, reminded us that health care is not a remote Washington issue. In New Jersey, 1.3 million are without health insurance, U.S. census data show.

An estimated 26 million people nationwide will remain without coverage once the law is fully implemented, including people who don't sign up and choose to face the penalties instead and those who can't afford it even with the subsidies. Illegal immigrants are not entitled to the new insurance coverage under the law, and will remain one of the biggest groups uninsured.

Republican Gov. Chris Christie said he is disappointed the court upheld key parts of the law, but did not say if he would try to guide New Jersey to buck two key provisions for states under the federal law: expanding access to Medicaid and setting up a new health insurance exchange.

"Today's Supreme Court decision is disappointing, and I still believe this is the wrong approach for the people of New Jersey who should be able to make their own judgments about health care," Christie said in a statement. "Most importantly, the Supreme Court is confirming what we knew all along about this law -- it is a tax on middle-class Americans."

Christie vetoed an exchange last month, saying he wanted to wait for the court ruling before committing money to it. At the time, the governor said he would move ahead with the state's part of the deal if the law were upheld.

State Democrats reintroduced the exchange legislation shortly after the decision was announced.

Congressmen, senators and candidates were similarly divided.

The Associated Press contributed to this report.