FLUSHING, Queens – It was not long after President Barack Obama spoke from the East Room on the Supreme Court’s ruling of the Affordable Care Act (ACA), when Sheryl Albrechd left the New York Queens Hospital to walk along Main Street. She was alone, her ailing husband remained bedridden inside the towering building.

Unlike 18 percent of Queens residents between 18 and 64-years-old, the Albrechd’s have health insurance. Sheryl’s husband Richard is 60-years-old and is “critically ill,” having spent more than a month living in hospitals and rehab facilities. They have yet to face any insurance obstacles although Sheryl recognizes the significance of the Act.

“It’s important for everyone to have coverage,” said Sheryl, 60, of Bayside. “You never know what’s gonna happen.”

On Thursday, the Supreme Court upheld the ACA, deeming it constitutional with a 5-4 ruling. The act’s components will take full effect in 2014.

The ACA requires citizens to have health insurance, whether individuals receive it through their employers or buy it in a state-sponsored exchange. Citizens who do not purchase health insurance will be subject to a fine. The ACA bans insurance companies from denying coverage to people with pre-existing conditions, prevents limits on health care coverage payouts and requires insurers to cover preventive care with no additional costs.

The law allows parents to keep their children on family coverage plans, regardless of their children’s education status, until the age of 26.

“For the kids staying on the parents insurance I think that’s great,” said Joy Randolp of Flushing. “I got kicked off of my parents insurance as soon as I graduated college. I had to go get a job to make sure I got my own health insurance.”

Dr. Robert Mittman, a Queens native and the owner of Allergy & Asthma Family Care on Bell Boulevard in Bayside spent the past few months campaigning for the boroughs 6th Congressional District seat. He recently finished in fourth place and is working once again at his practice.

“Overall I think it’s something that’s needed,” Mittman said. “I think we have to work towards revising health care in this country.”

As a doctor for 25 years, Mittman supports the Act’s concept but thinks certain parts are potentially damaging. One of Mittman’s biggest concerns is the negative effect it could have on small businesses like his, due to the additional expense of employee health insurance that owners will be required to pay.

“I think it’s going to hurt the economy, it’s basically an anti-small business act, ” he said. “It could knock down the profit margin or it could mean the difference between surviving and not surviving. It could mean the difference between being able to continue business or not continue business.”

Approximately 50 million Americans are currently uninsured. The medicaid provision in the ACA is projected to add 30 million more low-income Americans to the program, although the states can opt out if they choose.

In a Kaiser poll from January, 67 percent of the public was not in favor of the ACA and 54 percent said the Supreme Court should rule the individual mandate unconstitutional.