The U.S. Supreme Court upheld President Barack Obama’s health care reform in a 5-4 vote Thursday.

After years of debate over the constitutionality of what has been coined “Obamacare,” the Court ruled in favor of what is said will be Obama’s signature presidential achievement.

The Affordable Care Act requires that all Americans have “minimum essential” health insurance coverage.

The Court ruled that passing this law was within Congress’ power, as long as the law is considered a tax and not a mandate.

The health care reform issue has polarized voters since before Obama took office.

“Whatever the politics, today’s decision is a victory for people all over this country,” said Obama Thursday. “The highest court in the land has now spoken. We will continue to pass this law.”

The deciding vote was cast by Chief Justice John Roberts, who sided with the liberal justices on the Court.

Justices Roberts, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan were the five justices who ruled in favor of the legislation. Roberts wrote the opinion of the court, which explained that the Court was not considering the politics behind the health care issue.

“We do not consider whether the act embodies sound policies,” wrote Roberts. “That judgment is entrusted to the nation’s elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenged provisions.”

Roberts has traditionally been one of the most conservative justices on the Court. His decision has resulted in some backlash from conservative supporters, including some members of the OSU College Republicans.

“Obviously we were disappointed with the result …That being said, a lot of good came out of this as well,” said president of College Republicans Drew Stroemple, who described a tightening of the commerce clause, more defined limits of executive power, and financial donations he called “record-breaking” to Romney’s campaign in the 24 hours after the ruling was announced.

Stroemple said the ruling has “energized the conservative nation.”

The Court also upheld the congressionally expanded Medicaid under the act, but made it clear that if states do not comply with the expansion provisions, the federal government could not withhold existing funds, only refuse to provide new funds.

Justice Anthony Kennedy, joined by justices Antonin Scalia, Clarence Thomas and Samuel Alito all voted against the legislation. Kennedy wrote the dissent.

Republican presidential candidate Mitt Romney awaited the Court’s decision in Washington D.C., where he gave a dissenting opinion of the ruling shortly after it was announced.

Romney opened by reiterating that he would work to repeal Obamacare if he were to win the November presidential election. He also clarified what the ruling meant.

“Let’s make clear that we understand what the Court did and did not do. What the Court did today was say that Obamacare does not violate the Constitution,” he said. “What they did not do was say that Obamacare is good law or that it’s good policy.”

Romney used the ruling to advocate for his presidential campaign.

“Our mission is clear. If we want to get rid of Obamacare, we are going to have to replace President Obama. My mission is to make sure we do exactly that,” said Romney after the ruling was announced.

The medical community at large has been a proponent of the legislation since it was introduced, and the sentiment was affirmed Friday by Steven Gabbe, CEO of the Wexner Medical Center.

“The decision supports our goals and objectives we established years ago,” he said. “We want to be the healthiest university in the country, and we want to bring that to other members of the community.”

Gabbe called the Affordable Care Act “health care rather than sick care.”

Representatives from the OSU College Democrats did not return requests for comment.