BOULDER — Local health-care industry leaders are generally supportive of a U.S. Supreme Court ruling to uphold President Barack Obama's federal health-care reform law — including a controversial plan to require virtually all Americans to carry health insurance by 2014.

The Patient Protection and Affordable Care Act was approved by Congress and signed into law in 2010. It has been derided as "ObamaCare" by critics and is a key issue in the 2012 presidential election.

In Boulder, health care remains a top issue for Boulder Chamber members, 90 percent of whom own small businesses, said Angelique Espinoza, a chamber spokeswoman. Nationally, about half of all uninsured residents are small-business owners, their employees or dependents, Espinoza said.

"Most (members) agree that the steady increase in health-insurance premiums is unsustainable and that some kind of reform is needed," Espinoza said. "With our diverse membership, however, there is not agreement on the political aspects of the debate."

The new Colorado Health Benefit Exchange is expected to bring "greater predictability" to health-care costs, Espinoza said.

Local insurance broker representatives at Taggart & Associates in Boulder and Volk & Bell Benefits LLC in Longmont said they'll continue to work with customers on insurance benefits. If the Health Benefit Exchange is to involve existing brokers, they said they're ready to help.

"Taggart will continue to work with our clients to comply with the law and make the best decision for their companies and their employees," said Denise Dougherty, manager of the employee benefits department at Taggart. "Our hope is that brokers will be part of the exchange."

In light of the Affordable Care Act's passage in 2010, Volk & Bell expanded its offerings in human-relations consulting, said Ryan Volk, senior benefits consultant at Volk & Bell.

"For what it's worth, this is going to just make things more complicated, and they're going to need advisers more than ever," Volk said. "We've still got a (presidential) election coming up, and there are a lot of moving parts."

The Mountain States division of insurance provider Cigna Corp. (NYSE: CI) plans to participate in the new Colorado Health Benefits Exchange, following the Supreme Court decision. The bulk of Cigna's customers are expected to continue to come through private companies, however, said Kim Bimestefer, president and general manager of the Denver location. Cigna has about 40,000 customers in Boulder County.

"Our customers should have great comfort that all of the initiatives and programs we have today and going forward are focused on improving their health and well-being," Bimestefer said. "In general, this is positive."

Hospitals have taken a variety of steps to be ready for changes coming down the pike as part of the Affordable Care Act, said Karen Logan, a spokeswoman at Longmont United Hospital.

"We've been moving forward since this was passed," Logan said. "The hospital wants to provide proper health care for the community, and we're going to do whatever we're charged to do from the government."

The Supreme Court ruling is "our best shot to lower health-care costs and improve quality," said John Sackett, chief executive of Avista Adventist Hospital in Louisville. "It gives us tools to organize ourselves in a way that we can avoid duplication of costs and benefit from providing patients better care at a lower cost."

Sackett said he's "excited about the bill," even though he also said it will need to be "tweaked" going forward.

Dr. Laird Cagan, former president of the Boulder County Medical Society, said he was "pleased" by the Supreme Court ruling in general, but critical of one key piece of the justices' decision that relates to Medicaid. The court said expansion of Medicaid is constitutional, but that Congress cannot take away existing Medicaid funding from states that refuse to participate in the expansion.

"The only negative is that states are going to decide what the cutoff is for Medicaid recipients," Cagan said, "so there may be a lot of low-income people who still won't have medical coverage."

Medicaid access actually could get better as a result of the decision, however, Susan E. Birch, executive director of the state's Department of Health Care Policy and Financing, said in a press statement.

"Today's decision means that more uninsured Coloradans could gain access to Medicaid beginning in 2014," Birch said. "We will spend the coming weeks further analyzing the specific impact of the decision."

State Attorney General John Suthers was critical of the Supreme Court decision, which he said is a blow to the United States' constitutional system of federalism, in which state and federal governments balance power.

"I am disappointed that the U.S. Supreme Court ruled against Colorado and its fellow states," Suthers said in a statement. "We have a fundamental interest in protecting state authority and individual rights in the face of the ever-widening scope of federal power."

Suthers had been among 26 state attorneys general who sued the federal government to challenge implementation of the law. He does not plan any further challenge to the ruling at this time, however, according to a spokeswoman in the attorney general's office.