The United States Supreme Court's decision to uphold the health care law means that medical professionals and health care advocates now have some certainty.

They also have a lot of work to do.

By a 5-4 decision, the court ruled that the Patient Protection and Affordable Care Act -- called Obamacare by the law's opponents -- is constitutional.

Pieces of the legislation will continue to be phased in with the largest and most controversial piece -- the individual mandate -- coming on line in 2014.

Many people believed that the mandate -- or the requirement that people purchase health insurance or pay a tax -- would be overturned by the court.

If the court decided to invalidate the mandate, there was a question of whether the law could have been enacted since the mandate served as the law's funding mechanism.

Instead, the court decided to uphold the mandate, according to Richard Garnett, associate dean for faculty research and professor of law at the University of Notre Dame.

The court rejected the administration's claim that the mandate was a constitutionally protected use of the commerce clause, Garnett said. Instead the court ruled the mandate constitutional under Congress' authority to tax, Garnett said.

While the decision ends the legal arguments, the political and policy debates will continue, he added.

"This just ends one chapter," Garnett.

The political debate will continue at least through November's presidential election, he said.

Still, the ruling means that doctors, hospital administrators and community health advocates can focus on fully implementing the legislation and educating consumers and employers about the law's impact.

Philip A. Newbold, CEO of Beacon Health System, the new parent organization for Memorial Hospital, said that some of the more popular pieces of legislation have been phased in over the past two years.

These include a drug benefit for seniors, the guarantee that people with pre-existing conditions will be covered, the ability for parents to keep their adult children on their insurance until they turn 26 years old and prohibiting insurers from charging penalties and co-payments for preventive care, Newbold says.

Albert Gutierrez, the president and CEO of Saint Joseph Regional Medical Center, said that a major effort was made to educate patients and employers about changes that will affect the way health care is delivered and paid for.

For example, the law has deadlines in which some employers are going to have to decide to provide health coverage for their workers, Gutierrez said.

Hospital administrators have been working to educate employers about those deadlines and that work will continue, he adds.

"Small employers who are 80 to 90 percent of all employers in St. Joseph and Elkhart County, are going to have to make a major decision," Newbold said. "Do I stay involved in offering health insurance or do I ask my employees to get insurance through (the state operated) exchanges."

He said that some employers will opt to discontinue coverage and move