I said I wasn't going to do this, but I have a couple of quick thoughts that I don't think ought to be terribly controversial.
1. It seems that the Court has decided that the penalty for not having insurance is a tax, and that this is something that Congress has the power to do. I suppose reasonable people can disagree over the first point, but the second is pretty clearly spelled out in Article I.
2. Regardless of what you think of the outcome of this particular case, the fact that this was not a ruling that expanded further the scope of the Commerce clause is a good thing if you care about unchecked legislative power, generally.
3. Whether the ACA is constitutional, whether it is good policy, and what it means politically for certain interested parties are three completely separate questions, and the Court is only to be concerned with the first. I am not convinced that the ACA is particularly good policy, but I also find the status quo it purports to remedy indefensible. At least now, we have a chance to find out whether or not it will deliver as promised, rather than having it gutted and have to start over from exactly where we were. That may or may not turn out to be a good thing, but there really is only one way to find out...