Advocates are hailing the U.S. Supreme Court’s decision to uphold sweeping changes to the nation’s health care system as a victory for people with disabilities.

The high court ruled Thursday that the nearly all of the Affordable Care Act is constitutional, paving the way for additional provisions of the 2010 law to take effect between now and 2014.

As Democrats applauded the decision, Republicans promptly vowed to repeal the act. Meanwhile, leaders from a host of national organizations representing individuals with developmental disabilities praised the decision.

“People with disabilities and their families have their lives dictated by the status of their health insurance,” said Katy Neas, senior vice president of government relations at Easter Seals. “The Supreme Court’s ruling today tells these families they can make decisions about what is best for them as a family, and not be controlled by fear of losing health insurance coverage.”

President Barack Obama’s signature legislative accomplishment, the health care reform law includes a number of provisions — many of which have yet to be fully implemented — that advocates say are significant for people with disabilities including:

• No more lifetime coverage limits on health insurance plans.
• Insurers will not be allowed to charge higher rates or deny coverage to those with pre-existing conditions, including disabilities.
• Establishes the Community First Choice Option offering states the opportunity to receive increased federal matching funds to support community living.
• Requires health insurance plans to cover a menu of “essential benefits” including mental health services, habilitation and rehabilitation services as well as behavioral health treatment.

More than two dozen states challenged the constitutionality of the health care reform act, arguing that the law oversteps the bounds of federal authority. But the Supreme Court’s 5-4 ruling this week upheld nearly all of the law including the requirement that Americans must purchase health insurance or face a penalty starting in 2014.

“For millions of Americans with disabilities who rely on home and community based services to live, learn and earn in America, the ruling today by the Supreme Court on the Affordable Care Act is arguably the most significant decision since passage of the Americans with Disabilities Act 22 years ago,” said Jonathan Young, chair of the National Council on Disability.

The justices did rule against one provision of the health care law, however, that’s causing some concern among disability advocates. The Affordable Care Act called for states to expand Medicaid to include those earning up to 133 percent of the federal poverty level — currently about $14,856 for a single person — or lose out on federal funds. But the court said that such a mandate could not be imposed.

If the ruling leads states to decide against the Medicaid expansion, many people with disabilities could be shortchanged if they earn too much, said Marty Ford, director of public policy at The Arc.

Nonetheless, Ford said she’s optimistic that states will opt in given that they stand to gain significant federal funding for increasing their Medicaid rolls.

“I think in the end when the states take a look at what’s offered for Medicaid, it’s a tremendous gift,” Ford said.