MONTGOMERY, Ala. (AP) — Alabama Gov. Robert Bentley said Thursday he is "deeply disappointed" with the U.S. Supreme Court ruling upholding much of the federal health care law.

Bentley issued a statement shortly after the Supreme Court's ruling was announced saying that the health care act created more regulation and bureaucracy. He called the health care act the worst legislation to ever come out of Congress and that it must be repealed.

Bentley, a physician, issued a statement with his reaction within minutes after the ruling was released.

While most of the official reaction to the court's decision in Alabama, where much of state government is controlled by Republicans, was negative, the head of an advocacy group for Alabama's poor praised it.

"In a high-poverty state like Alabama, the Affordable Care Act provides tools to break the chain linking low income to poor health," said Kimble Forrister, executive director of Alabama Arise. He said 750,000 Alabamians, including 100,000 children, are without health insurance. He said that statistic contributed to Alabama's high ranks in some national measures of chronic health conditions and other health risks.

Alabama officials were particularly concerned about the effects of the ruling on the state's Medicaid program.

The ruling put some limits on the law's plan to expand the Medicaid insurance program for the poor, a joint effort of the federal government and states. The court said the U.S. government cannot threaten to withhold a state's entire Medicaid allotment if it doesn't participate in the expansion. State Health Officer Don Williamson, who is temporarily overseeing Medicaid funding, said the Supreme Court left it up to the states to decide whether to expand Medicaid or not. He said the decision will be up to the Legislature and the governor.

Bentley press secretary Jennifer Ardis said the governor had not decided if he would favor expanding Medicaid rolls or not.

"We don't know if the state can afford it. We need to study the full implications of the ruling," Ardis said.

But the chairman of the House committee that prepares the General Fund budget, Republican Rep. Jim Barton of Mobile, said expanding the rolls would mean the state would have to spend more on Medicaid at a time when it can't afford it. The state struggled to fund Medicaid adequately in the budget for the next fiscal year and passed a spending plan dependent on voters in September approving a referendum transferring money from other areas into the General Fund.

If the ruling adds more people to Medicaid roles "I don't know how we will handle it," Barton said.

Republican House Speaker Mike Hubbard of Auburn said the ruling would hurt most Alabama residents.

"Today's ruling is a victory for government-loving bureaucrats and a loss for taxpayers and small businesses," Hubbard said.

Alabama Attorney General Luther Strange said at a news conference that he disagrees with the court's ruling. He said it will be costly to states that will now have to pay for the mandates in the act.

"Make no mistake, the consequences of today's decision are dire," Strange said. "I, along with other conservative state attorneys general, will continue to stand on the front lines of protecting liberty and pushing back against an ever-encroaching federal government."

The state director of the National Federation of Independent Business, Rosemary Elebash, appeared at the news conference with Strange and said the ruling to uphold the individual mandate would hurt small businesses.

"Under the health care law, small-business owners are going to face an onslaught of taxes and mandates, resulting in job loss and closed businesses," Elebash said.

The director of Appleseed Alabama, a nonprofit advocacy group that works on a number of poverty issues called the Supreme Court's decision "courageous."

"For too long many Alabama families have gone without access to both preventative medical care and acute medical care for illnesses and accidental injuries," John Pickens said. "Today's decision will reverse that trend and set us on a new road so that every Alabamian will have access to affordable and quality health care."