MORGANTOWN (AP) — West Virginia’s top Democrats offered mixed reviews to the Supreme Court’s ruling upholding the federal health care overhaul Thursday, while a businessman involved in the case said he was astonished by the outcome.

Gov. Earl Ray Tomblin said he would review the ruling and work with the state’s bipartisan congressional delegation to determine how to proceed.

“We know what the law is, but as I’ve said before,” he said, “I will continue to do what is best for West Virginia.”

U.S. Sen. Joe Manchin said Congress still needs to repair the legislation put forth by the administration of President Barack Obama, “fixing what is wrong with this bill and saving what is right.”

Manchin believes parts of the law are good for West Virginians, such as ending discrimination against people with pre-existing conditions and improving access to preventive care. But he said the requirement that uninsured individuals purchase coverage or pay a fine “doesn’t make sense to West Virginians.”

Manchin and Tomblin are often at odds with Obama. They have refused to say whether they voted for Obama in West Virginia’s May primary and are not attending the Democratic National Convention.

U.S. Sen. Jay Rockefeller embraced the ruling but expressed concern about how Medicaid and poor people will be affected.

“This law is not perfect. No law ever is,” he said. “But there simply is no moral justification for anyone sitting back when individuals and families throughout our state — often our own friends and neighbors — don’t have health insurance.

“It’s real people in West Virginia who I’m concerned about,” he said, “not keeping score in Washington.”

U.S. Rep. Nick Rahall, the only West Virginia Democrat in the House, also backed the decision.

“As long as this law remains in place,” he said, “no American will lose their health coverage when they need it most, or fall into bankruptcy because of a lifetime limit on their coverage, or be denied coverage because of a pre-existing condition.”

About 244,000 West Virginians — or about 13.5 percent of the population — are currently uninsured.

The federal law will require states to open their programs starting in 2014 to people who earn less than 133 percent of the poverty level. That equates to around $14,800 annually for a single-person household.

West Virginia officials estimate the change will make an additional 140,000 additional residents eligible for the state’s program. Federal funding will cover this expansion entirely — but only for the first three years.

West Virginia now has among the strictest qualifying thresholds for Medicaid, leaving it largely for the disabled and the children of the working poor.

Around 330,000 West Virginians received their health care through Medicaid in 2010, according to the latest U.S. Census Bureau estimate. Only 11 states had a higher percentage of its residents relying on this government program for coverage.

Tomblin and the Legislature put aside $65 million in surplus general tax revenues during the budget year that ends Saturday to ensure sufficient Medicaid funding during the next one. At Tomblin’s request, the Legislature budgeted an additional $132 million for Medicaid to that new spending plan.

State Republicans, meanwhile, denounced the ruling and renewed calls for a full repeal.

“While I respect the Supreme Court’s decision, I continue to believe that this law is bad for West Virginia families and the American economy,” said Republican U.S. Rep. Shelley Moore Capito. “I have voted to repeal, dismantle and defund this law multiple times, and I will once again cast my vote for repeal in July.”

Republican businessman John Raese, who is challenging Manchin, said a full repeal is the only solution to a law he says “will worsen our economy, expand the size of our government further, and will be nothing but a failure.”

Republican Rep. David McKinley, meanwhile, argued the law is based on “dubious Constitutional authority.”

“Restricting choice and punishing individuals and employers is the wrong way to reform health care, whether the court agrees or not,” he said.

David Klemencic, owner of Ellenboro Floors in Ritchie County, was one of a handful of individual plaintiffs directly involved in the lawsuit. He opposes the requirement that most people obtain health insurance or pay a penalty, among other things.

Klemencic said the ruling that the individual mandate constitutes a tax “blindsided everyone involved with it.” He was among the few individual plaintiffs in the courtroom when the justices heard arguments and said he “really heard no argument to uphold it.”

“The bill is 2,700 pages long, and admittedly nobody has read it from cover to cover,” he said. “So I was in hopes that the justices would think, ‘This is a mess. It’s just too convoluted.’

But Klemencic said it’s too soon to suggest what should happen next.

“Right now,” he said, “we need to dust ourselves off and find out exactly where things stand.”