TRENTON — For Gov. Chris Christie, the clock is now ticking.

The Supreme Court's long-anticipated ruling on the nation's sweeping health care overhaul landed on the desk of every governor in the country Thursday — and with it, a deadline.

Every state must create an "exchange," or online marketplace, by January 2013 that will help people shop and pay for health insurance. The law expects exchanges to begin enrolling people by Oct. 1, with coverage beginning in January 2014.

Christie, who opposed the health care changes pushed by the Obama administration, vetoed legislation last month that would form an exchange in New Jersey, saying he wanted to wait until the Supreme Court determined whether the Affordable Care Act was constitutional.

In the wake of the Thursday’s ruling, the Republican governor said he would meet any deadlines imposed on the state. But on his monthly radio call-in program on 101.5 FM last night, he called the Supreme Court decision "a screwy opinion," and promised to again veto the bill Democrats in the Legislature now want to re-introduce.

Christie, in an earlier statement, said he believed the health care law mandating universal coverage " is the wrong approach for the people of New Jersey who should be able to make their own judgments about health care. Most importantly, the Supreme Court is confirming what we knew all along about this law — it is a tax on middle class Americans."

Christie said he did not believe a one-size-fits-all health care program works for the entire country and that each governor "should have the ability to make decisions about what works best for their state."

Democrats who control the Legislature, meanwhile, immediately set about to implement requirements under the federal health care law.

Sen. Nia Gill (D-Essex), chairwoman of the Senate Commerce Committee, said she was re-introducing the health exchange bill the governor vetoed in May.

RELATED COVERAGE:



• U.S. Supreme Court upholds individual mandate in Obama health care act

• Health care ruling brings disappointment, but certainty to New Jersey business leaders

• Health care law Q&A: A look at the Supreme Court's decision

• Obama handed significant political victory in Supreme Court ruling to uphold health care law

• Obama health care law upheld by Supreme Court: Read the full decision

• Health care law: What the historic Supreme Court ruling means

• Dewey Defeats Truman, again; some news organizations got the health care news wrong

"Now that we have validation the law is constitutional ... we must move forward with the implementation of a state-based health exchange that allows individuals and businesses to shop for insurance in a transparent virtual marketplace and to access federal subsidies that will make care more affordable," Gill said.

But Christie vowed on the radio call-in program to veto the exchange bill again if it lands on his desk. Joel Cantor, director of the Center for State Health Policy at Rutgers University, said Christie has three options.

"He could let the federal government create the exchange, but he and other lawmakers have long said they would not allow that," Cantor said. The governor and Legislature could revise the bill he vetoed. Or, he could issue an executive order creating the exchange, "and leave the Legislature out of the picture," Cantor said.

Sen. Joseph Vitale (D-Middlesex), chairman of the Senate Health, Human Services and Senior Services Committee, said the bill that will be introduced is the same one the governor vetoed — for now.

"It can be amended to address some of the concerns the governor has," such as the $50,000 salaries for the board members who will oversee the exchange, said Vitale, also a sponsor. "We have until October 2013 and that time goes by quickly. We should work on it over the summer."

Seton Hall Law Professor John Jacobi, faculty director for the Center for Health & Pharmaceutical Law and Policy, said he doesn’t think the governor can do this alone.

"There are some things he could do to get it up and running, but New Jersey cannot spend money by executive order," Jacobi said. Nor can Christie change state law without the Legislature, and that is what would be required if the two struggling and highly expensive state-run insurance programs, for small employers and individuals, are folded into the exchange, he said.

It may be politically difficult for the governor to, in one breath, condemn the ruling, keeping with presumptive GOP presidential nominee Mitt Romney’s position, while at the same time accept billions of dollars in Medicaid reimbursements and money for subsidies and tax credits, said Raymond Castro, senior policy analyst at New Jersey Policy Perspective.

Many business leaders in the state don’t like the vetoed bill and want lawmakers to start over.

"The Affordable Care Act has been about coverage for not about controlling cost," said Christine Stearns, vice president of health and legal affairs for New Jersey Business and Industry Association. The bill adds "big layers of bureaucracy and cost," she said.

The conservative advocacy group, Americans for Prosperity, said defeating any state based exchange, "and other implementations of this dangerous job-killing legislation" would be a top priority, state Director Steve Lonegan said.

Within many facets of the health care industry, such as hospitals, the decision was welcomed.

"The decision validates the kind of work we and other hospitals have been doing. . .and allows out work to continue interrupted," said Skip Cimino, CEO of Robert Wood Johnson University Hospital in Hamilton.

Cimino said his hospital has saved $22 million since 2009 by making purchases and negotiating HMO contracts as part of the larger Robert Wood Johnson Health System, which includes the hospitals in New Brunswick and Rahway.

Star-Ledger staff writer Jenna Portnoy contributed to this report.