Several major South Florida healthcare leaders applauded the Supreme Court’s decision Thursday on the Affordable Care Act because they say it will bring more access to the region’s large number of uninsured and allow for providers to get paid for their care.

But doctors leading the Miami-Dade and Broward medical associations said they’re concerned whether physicians will be reimbursed enough under the new legislation. The leader of Florida Blue, the state’s largest health insurer, warned of increased healthcare costs ahead, while Jackson Health System leaders worried about considerable reductions in funding. And individual reactions ranged from calling the ruling a life-saver to decrying the decision as creating rampant socialism.

The stakes are huge for the region’s uninsured — 31.8 percent of Miami-Dade residents, 24 percent in Broward and 32 percent in Monroe County, according to 2010 Census data. The national average is 16.3 percent. Among adults from 18 to 64, the potential effect is even greater: 57 percent of Hialeah residents in that age group are uninsured, 50.4 percent in the City of Miami, 48.5 percent in Deerfield Beach. Even in middle-class Kendall, almost one-third — 31.2 percent — of adults aged 18 to 64 now have no coverage.

Some residents were happy with the ruling because it retained provisions of the law already in force. “I am thrilled,” said Leslie Rosenberg of Hollywood, responding to an inquiry from The Herald. “Last year, our 22-year-old son was diagnosed with a brain tumor just 10 days after graduating from college. Because of Obama’s health law, we’ve been able to keep him on our employers’ insurance policies (despite an extremely high cost) and have him receive outstanding medical care. A year later, he is doing well, and I believe it’s because we were able to have him covered by our policies.”

Al Rothstein, a Fort Lauderdale retiree, decried the act as a move by President Barack Obama “towards socialism,” possibly leading to a Republican backlash in November to kill the act. If that doesn’t happen, the act will lead to “increased healthcare costs and lowered quality of care,” Rothstein said, responding to an inquiry from The Herald.

“This is a big win,” said Donna Shalala, president of the University of Miami who in the 1990s tried and failed to win passage of healthcare reforms when she was secretary of Health and Human Services for the Clinton administration.

“It’s a win not just for those who are uninsured but also for those who do have insurance,” because providers have been shifting the costs of treating the uninsured to those who do have coverage, Shalala said. She called the reform act “a first step toward ending cost-shifting. ... It helps every emergency room across the state.”

Healthcare leaders were braced for the ruling in South Florida, where the large number of uninsured seeking access to healthcare account for $16 billion annually, a larger slice of the region’s revenue than tourism or construction.

When asked how she felt personally, after spending so many years trying to get reforms enacted, Shalala replied: “It’s thrilling, actually.”

Hospitals, now required to treat the uninsured in emergency rooms even though they rarely get paid for such care, appear to be the biggest winners. Linda Quick, president of the South Florida Hospital and Healthcare Association, sent out a one-word email moments after the decision was announced: “Yay!”