CHARLESTON, W.Va. -- State health-care advocates said Thursday's decision by the U.S. Supreme Court to uphold the federal health-care reform law will mean better care for more West Virginians.

FamilyCare HealthCenter's Director Martha Carter said her nonprofit group and other community health centers in West Virginia will "be at the forefront in the communities we serve" after the ruling.

The 5-4 decision from the court ruled that the individual mandate -- a key part of the law that requires Americans to buy health insurance or pay a penalty that Congress can enforce using its power to tax -- is constitutional.

"I'm thrilled. It gave me goosebumps," Carter said.

She said FamilyCare patients -- and all community health-care patients -- will have better access to health care. The Affordable Care Act will help people get access to benefits that they are now eligible for, she said.

Louise Reese, director of the West Virginia Primary Care Association, said she was extremely pleased with the Supreme Court's decision.

Community health centers have been an integral part of the Affordable Care Act, Reese said.

For West Virginians, the decision significantly improves access to care and will change how the health-care system operates, she said.

By keeping the Affordable Care Act, it ensures that the health center program has been fully funded and that they will not see any reduction in support for the programs that they provide for the uninsured, Reese said.

One in five Mountain State residents depends on community health centers for health-care services, Reese said.

Perry Bryant, executive director of the group West Virginians for Affordable Health Care, said at least 150,000 more West Virginians will be insured under the Affordable Care Act.

"This does preserve the greater security for West Virginia's families on health-care security. Once implemented, people will always have access to health care, [which] is something we've never had in this country," Bryant said. "It means we don't have to start all over again."

But Bryant said he was perplexed and surprised at the logic of counting the health insurance mandate as a tax. The Supreme Court rejected two of the Obama administration's three justifications for the mandate, but agreed with the argument that it could be construed as a tax, which is constitutional.

The decision is a tremendous victory for women and their families -- including the 50 million Americans without insurance -- who will be insured, said Margaret Chapman Pomponio, executive director of WVFREE, a nonprofit women's health rights group.

Women will no longer have to pay more money than men for the same insurance plans, Pomponio said.

"We've been working hard on this for a number of years ... so this is a really gratifying day for WVFREE, because it marks the next step in health care for all people," Pomponio said. "The law's not perfect, but it's a huge step forward."

Women will also be healthier, which will save money over time, she said.

Reese acknowledged that people will talk about what this decision will cost Americans, but she said over time, health-care costs will go down.

For example, she said, fewer people will visit emergency rooms, because they'll be getting better primary care up front.

The state will save money over time with improvements in behavioral health and Medicaid, said Sen. Dan Foster, D-Kanawha, at a press conference at the state Capitol on Thursday.

Now that the Supreme Court has spoken, West Virginia has much to be thankful for, Foster said.

"My hope is that West Virginia will be a leader," Foster said.

Aila Accad, a vice president for the West Virginia Nurses Association, said nurses are delighted with the ruling. The new focus will put health back into health care, she said at the meeting.

"What nurses are seeing is that it's changing the perspective so people can get help sooner," Accad said.

The Supreme Court found one part of the law unconstitutional: Medicaid expansion can't deny states all of the Medicaid funds if they fail to participate in the expansion.

"Now it's time to roll up our sleeves and continue the work on the implementation of the Affordable Care Act," Pomponio said, referring to the health-care insurance exchange West Virginia and all other states are supposed to set up under the law.

"Working with the state to ensure that the exchanges are set up to maximize access for West Virginians and to get the message out to West Virginians exactly what the benefits will be and exactly how the exchange will improve their everyday lives," she said.

Bryant said implementing the Affordable Care Act is going to be heavy lifting, since "we're going to have to work very hard to implement the Act now to get the exchange up and running."

Reach Megan Workman at megan.work...@wvgazette.com or 304-348-5113.