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Patient Joan West, left, receives a check up from Dr. Lisa Vinci as her husband, Thomas, looks on at University of Chicago Medicine Primary Care Clinic in Chicago on Thursday. A sharply divided U.S. Supreme Court on Thursday upheld the centerpiece of President Barack Obama's signature health-care overhaul law that requires that most Americans get insurance by 2014 or pay a financial penalty.Jim Young/Reuters

The Supreme Court's landmark decision that upholds President Barack Obama's health-care reforms will impact nearly every American by the time they are fully rolled out in 2014. Essentially, it means everyone must have health coverage and guarantees it will be given to them even if they are already sick with a pre-existing condition.

The ruling, however, limits the law's ability to expand the Medicaid insurance program for the poor in individual states, a cost that they currently share with Washington. The court said the federal government cannot withhold a state's Medicaid funding if it does not expand the program, which mean cash-strapped states won't be further burdened by the law.

The law mandates that by 2014 nearly all Americans have to have health insurance or pay a fine. The court describes the fine as a tax – not a requirement. The language is significant because the federal government has the right to impose taxes.

For those who cannot afford health insurance, there are new subsidies available.

The law, introduced in 2010, will continue to roll out, extending coverage to roughly 30 million uninsured Americans by 2014, when the fines come into full force. However, an estimated 26 million people will remain without coverage even after the law is fully in effect, including illegal immigrants and those who cannot afford it, even with the subsidies.

Co-payments for preventative health care, such as immunizations, for Americans of all ages have been eliminated.

Young Americans are eligible to remain on their parents' insurance until the age of 26. Insurance companies can no longer refuse coverage to children with health problems.

There are no longer limits on how much insurance companies pay out to a client over their lifetime.

Small-business owners will be eligible for billions of dollars in tax credits to help employees pay for coverage.

Employers who do not offer coverage to employees will faces fines.

Insurance companies will be prohibited from denying coverage to people with pre-existing medical conditions; charging women more for coverage; and dropping coverage while a patient is sick.