Most insurers, hospital executives and state officials expect they'll keep carrying out President Barack Obama's health care overhaul even after a federal judge cast its fate in doubt by declaring all of it unconstitutional.

"It's still the law of the land," said William Hoagland, vice president for public policy at health insurer Cigna. "We'll continue to proceed with its requirements, and (the ruling) will not slow that down. We have no other choice until this thing is resolved one way or the other." Insurers spent millions to block passage of the law.

Health care accounts for about one-sixth of the economy, and many players in the sprawling sector have a love-hate relationship with Obama's health care remake. There's dissatisfaction with key provisions, and a sense that parts may be unworkable. But at the same time, it's seen as a vehicle to start addressing problems of cost and quality that, left to fester, could trigger more drastic consequences.

"I don't think people are going to hit the stop button," said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the consulting firm. "You probably don't make the big bets right now, but you make the incremental investments in case you have to make the big bets 6 or 12 or 18 months down the road. Everyone proceeds with an informed approach."

Monday's ruling by U.S. District Judge Roger Vinson in Florida had been expected to go against the Obama administration. But the scope of the decision in a lawsuit by 26 of the 50 states took some by surprise.

Vinson struck down the entire law after finding its requirement for nearly all Americans to carry health insurance unconstitutional. Another judge who reached the same conclusion in a separate case voided the individual insurance requirement and left everything else in place.