Health care reform will enable her group to help 50,000 residents gain access to care through Medicaid and as many as 80,000 to buy insurance with subsidies on the exchange, she said.
Maryland officials had pledged to find ways to continue implementation of some provisions if the court struck down the health care law but acknowledged that funding would have been an obstacle.
And though some insurers had pledged not to eliminate benefits they had already begun to offer under the law, state officials said they would not have been able to tell them to continue covering those with pre-existing conditions.
"There are some tremendous opportunities and resources the law provides that we would have lost," said Joshua M. Sharfstein, state secretary of health and mental hygiene. "We would have tried to move forward, but how successful it would have been I couldn't say."
Some say that spending so much money to cover so many people is not in Maryland's best interest.
House Minority Leader Anthony J. O'Donnell said the cost to implement reform in Maryland will be "staggering," especially once federal subsidies shrink as scheduled under the law. The Republican, who represents Calvert and St. Mary's counties in the General Assembly, said raising taxes would be the only way to pay for it and believes Congress should move to repeal the law.
Maryland Attorney General Douglas F. Gansler bemoaned that the law had become political fodder instead of a discussion about health care.
He wrote a "friend of the court" brief on behalf of several states that supported the law, arguing that Congress had the right to mandate that Americans buy health insurance as a means of regulating the economy under the Constitution's Commerce Clause. The court narrowly disagreed with that argument but upheld lawmakers' ability to require Americans buy health insurance under its taxing authority.
The outcome for consumers was no different, he said. "The bottom line is the Supreme Court found the Affordable Care Act is constitutional," he said. "There will be a dramatic increase in the number of Marylanders with insurance."
Other groups were split on the court decision and on the impact of the law, which aimed to cover more people and cut costs.
While the American Medical Association supported it, the state medical society MedChi opposed the measure. MedChi CEO Gene M. Ransom III said that while his group supports expanded health coverage, the reform didn't go far enough in addressing cost concerns, including threatened cuts to Medicare payments to doctors and malpractice liability.
Carmela Coyle, president and CEO of the Maryland Hospital Association, agreed that even more needs to be done to address growing medical costs and said the Obama bill isn't perfect. But her group supported reform and said that the court's health care decision will allow the state to continue to increase coverage for its residents.
"I think the Supreme Court decision replaces a lot of negative what-ifs with a single positive, and that is to change for the better the way we take care of people in the United States," said Coyle, whose organization represents 46 acute-care hospitals. "That is what health care reform was all about."
Insurers also said more needs to be done to identify methods of improving care and cutting costs.
"Health care modernization did not begin and must not end with the enactment of the Patient Protection and Affordable Care Act," UnitedHealthcare said a statement. The company "strongly supports making high-quality health care accessible and affordable for everyone. Now is the time to apply proven ideas and best practices to build a better health care system."
A spokesman for CareFirst BlueCross BlueShield, the state's largest health insurer, which supported the law, said the insurer would work with officials on implementation.
For their part, consumers are also split on whether the law is flawed. Many who have chosen not to buy insurance in the past will likely oppose it, said Douglas Hough, an associate professor in Johns Hopkins' Carey Business School.
A large number of Americans work part-time or two jobs that don't offer coverage, and they decided they couldn't afford a policy or they were healthy enough to go without, Hough said. But the behavioral economist said he believes most people will now buy coverage.
"The penalty for not buying insurance is not onerous, but since it's called a 'mandate,' people will buy insurance," he predicted. "That's a good thing because essentially it's the only way this will work, if the low-risk and high-risk people are included in the pool. … And most people buy insurance knowing they'll really have to use that insurance because pretty much everybody uses health care."
If an estimated 32 million additional people are insured through the law, that would put the United States more in league with other rich countries in terms of population covered, said Jeffrey Kahn, professor of bioethics and public policy at the Johns Hopkins University.
But he said Americans still haven't addressed the fundamental question answered in those other countries about whether health care is a "moral imperative." Rather, he said, it is viewed as more of a political and economic question. In contrast, he said, Americans have decided as a society that they want free education for all, health care for seniors and Social Security.
"This is a really significant moment in American health policy," he said. "But it remains to be seen if health care for all is embraced like the others."