The U.S. Supreme Court upheld the core of President BarackObama's health-care overhaul, giving him an election-year triumphand preserving a law that would expand insurance to millions ofpeople and transform an industry that makes up 18 percent of thenation's economy.

The justices, voting 5-4, said Congress has the power to makeAmericans carry insurance or pay a penalty. That requirement is atthe center of the law, which also forces insurers to cover peoplewith pre-existing medical conditions. The court modified the law'sextension of the Medicaid program for the poor by saying thefederal government can't threaten to withhold existing money fromstates that don't fully comply.

The ruling frames the health-care issue for this year'selections and is a victory of symbolism as well as substance forObama. Chief Justice John Roberts, a Republican appointee, joinedfour Democratic-selected justices to give Obama a majority on a lawthat has divided the country along ideological and partisan linesthroughout his presidency.

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