James Earle Frasier's "The Guardian" or "Authority of Law" sits outside the U.S. Supreme Court building in DC. (Mark E. Fisher/Flickr)

At long last, the ruling in plain English:

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional.

There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters.

Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding. 

Read the full searchable text here.

According to the live blog, Chief Justice John Roberts' vote "saved the ACA." Four conservative justices are in dissent of the decision, led by Justice Anthony Kennedy—"In our view, the entire Act before us is invalid in its entirety."

The law—formally titled the Patient Protection and Affordable Care Act—requires nearly all Americans to have coverage by 2014 or pay a fine. Exempt from the mandate: those with religious reasons who object, people in jail or prison, undocumented immigrants, people who would pay more than 8 percent of their household income to get coverage, people who don't earn enough to file a federal tax return and members of Native American tribes.

PBS reported some 18.2 million Americans, roughly 6 percent of the population, will have to purchase new coverage. Of them, 10.9 million will be eligible for government aid to pay for coverage, which leaves about 2 percent of the total population that will have to pay unassisted.

At issue was whether this violated citizens' constitutional rights. The court was left to decide whether the Commerce Clause gave the government the authority to force such a mandate on Americans.

According to Cornell University Law School:

Congress has often used the Commerce Clause to justify exercising legislative power over the activities of states and their citizens, leading to significant and ongoing controversy regarding the balance of power between the federal government and the states.

The Commerce Clause has historically been viewed as both a grant of congressional authority and as a restriction on states’ powers to regulate.

From SCOTUSblog editor Amy Howe: "The court reinforces that individuals can simply refuse to pay the tax and not comply with the mandate... The Court holds that the mandate violates the Commerce Clause, but that doesn't matter (because) there are five votes for the mandate to be constitutional under the taxing power."

As for Medicaid, Howe reports the Supreme Court has ruled the expansion constitutional, but said it would be unconstitutional for the federal government to withhold Medicaid funds for non-compliance with the provisions.

According to Politico, the court had to address four main questions: Is the individual mandate unconstitutional? If so, how much of the rest of the law should be struck down as well? Is the included Medicaid expansion constitutional? What about the tax law, aka the Anti-Injunction Act—can the court even rule on the issue before it goes into effect in 2014?

Howe: "The Court holds that the Anti-Injunction Act doesn't apply because the label 'tax' is not controlling."

Watch SCOTUSblog publisher Tom Goldstein's liveblog of the ruling and aftermath here.

So how does this ruling affect you? The Washington Post has a pretty neat tool to walk you through.

According to the Congressional Budget Office, 16 million fewer people would have gotten insurance under the law if SCOTUS had bumped the mandate but upheld the rest of the ACA. Insurance premiums would have risen 15 percent as companies took on more risk to cover an influx of sick people without anything forcing the healthy to also get coverage.

Read more of Neon Tommy's coverage on health care reform here. 

Reach Executive Producer Catherine Green here; follow her here.