Institutional health care providers in Suffolk have mostly welcomed Wednesday’s historic Supreme Court decision upholding the centerpiece of President Obama’s signature Patient Protection and Affordable Care Act, but they say a long road remains in adapting to it and improving upon it.

Bon Secours, which operates the Harbour View Health Center, views the decision upholding the constitutionality of requiring all Americans to have health insurance as “very positive,” Media Relations Director Lynne Zultanky said.

The Catholic health system supports the Catholic Health Association’s ongoing work with the U.S. Department of Health and Human Services to implement the act, she said.

“We have always been a health system who has looked for opportunities to improve access to health care,” she said. “We believe this is a step forward to help alleviate some of the challenges that we find on a regular basis.”

Zultanky described a wait-and-see approach on the issue of Medicaid, after the court ruled that the federal government cannot withhold Medicaid funding from states that resist expanding eligibility for the program.

“There’s some uncertainty as to how that will roll out,” Zultanky said. “We don’t have an answer to that” and it will probably be some time until the issue is resolved.

“We know we’re going forward, and much of the planning we have been doing is heading us in the correct direction, and we will work through the Medicaid issues when we find out more about it and work through it.”

Michael Dudley, senior vice-president for Sentara, operator of Obici Hospital, said the decision provides certainty, which will allow preparations for serving more patients.

“It does hold out the promise that people currently not covered … may be able to get coverage starting in 2014,” he said. “On the other hand, there are some provisions in the law that still might make it unaffordable.”

According to Vicky Gray, Sentara’s senior vice president for system development, more patients who otherwise end up populating emergency departments will have access to preventative medicine.

“There’s going to need to be more capacity to bring those folks in,” she said, saying advances in health care administration such as computerized records are already serving this purpose.

Dr. Ed Pelausa, a Suffolk physician, is “very much in support of health care reform” and applauds Thursday’s decision, but said the issue is far from completely settled.

“There’s going to be ongoing uncertainty for the next few years as America eventually goes into what most advanced countries in the world already have — universal health care,” he said. “What’s called ‘Obamacare’ is just a first step, and there’s going to be severe resistance, and not just from Republicans, but from a very conservative profession which is medicine.”

He said the generation of future American physicians currently passing through medical school, whose attitudes he says align with his own, understand that “this country can no longer be a pariah” among advanced nations by withholding universal health care from citizens.

Another Suffolk physician, Dr. Joseph Verdirame, said the decision means the end of two years of uncertainty over the fate of the act.

“People can now go forward with certainty,” he said.

Citing the New England Journal of Medicine, he said coverage will be extended to an extra 32 million people, “but there will still be a clientele to serve” for organizations such as the Western Tidewater Free Clinic, whose board he serves on.