Chief Justice John G. Roberts Jr. on Thursday joined the liberal wing of the Supreme Court to save the heart of President Obama's landmark health-care law, agreeing that the requirement for nearly all Americans to secure health insurance is permissible under Congress's taxing authority.

Even as it upheld that central component of the Patient Protection and Affordable Care Act, however, the court modified another key provision of the law, ruling that states may decide not to participate in a broad expansion of Medicaid eligibility without losing their existing Medicaid funding.

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