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The Supreme Court also allowed individual states to opt out of a major Medicaid expansion under the law. The Obama administration says it will exempt low-income people in states that opt out from having to comply with the insurance requirement.

Many Republicans still regard the insurance mandate as unconstitutional and rue the day the Supreme Court upheld it.

However, the idea for an individual insurance requirement comes from Republican health care plans in the 1990s.

It’s also a central element of the 2006 Massachusetts health care law signed by then-GOP Gov. Mitt Romney, now running against Obama and promising to repeal the federal law.

Romney spokeswoman Andrea Saul said Wednesday the new report is more evidence that Obama’s law is a “costly disaster.”

“Even more of the middle-class families who President Obama promised would see no tax increase will in fact see a massive tax increase thanks to Obamacare,” she said.

Romney says insurance mandates should be up to each state. The approach seems to have worked well in Massachusetts, with virtually all residents covered and dwindling numbers opting to pay the penalty instead.