海角大神

The US Supreme Court has spoken. Let the politics begin.

Opponents of President Obama鈥檚 health-care reform are enraged, following the high court鈥檚 unexpected 5-to-4 ruling Thursday that upheld the law, including the controversial individual mandate to purchase health insurance. Supporters of the law are ecstatic, having braced themselves for defeat.

Immediately, the issue is thrust into the center of the presidential campaign, as well as House and Senate races. Republicans, including presidential candidate Mitt Romney, insist the law must be repealed and replaced. But for any legislation to defund or overturn the law to be enacted, the GOP must take control of both houses of Congress and retake the White House.

鈥淭his is a time of choice for the American people,鈥� Mr. Romney said after the court ruling. 鈥淥ur mission is clear. If we want to get rid of 鈥極bamacare,鈥� we鈥檙e going to have to replace President Obama.鈥�

Romney called the health-care law a 鈥渏ob-killer鈥� that raises taxes, cuts Medicare, and adds trillions to the national debt and deficits. He also maintained that as many as 20 million Americans will lose their current insurance.

鈥淎nd perhaps most troubling of all, 鈥極bamacare鈥� puts the federal government between you and your doctor,鈥� Romney said.

In addition, the Supreme Court majority鈥檚 surprise finding that the penalty for not buying insurance is a 鈥渢ax鈥� 鈥� which allowed the court to work around the Commerce Clause of the Constitution 鈥� fuels the old arguments about 鈥渢ax and spend Democrats.鈥澛�

These are the talking points that Republicans will use heading into the fall elections. But for the GOP, having Romney as the effective head of the party is awkward, given his leadership as governor of Massachusetts in instituting a health reform that served as the model for Obama鈥檚 plan. Romney has maintained that health care should be handled at the state level, and that what works for Massachusetts isn鈥檛 necessarily right for the nation. Still, on this issue, he鈥檚 not the party鈥檚 cleanest messenger.

Moments after Romney spoke, Obama weighed in from the East Room of the White House. And just as House Speaker John Boehner (R) had warned his caucus last week against 鈥渟piking the ball鈥� in anticipation that 鈥淥bamacare鈥� would be overturned, Obama, too, seemed to be following that advice. He spoke in well-modulated tones, barely smiling, as he insisted that the politics of the matter were beside the point.

鈥淲hatever the politics, today鈥檚 decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court鈥檚 decision to uphold it,鈥� Obama said.

The president then focused on the aspects of the law that are already popular, such as the guarantees of coverage despite someone's pre-existing health conditions and the ability of young adults up to age 26 to be included on their parents鈥� insurance plan.

He also acknowledged the controversy around the unpopular individual mandate, which he had not supported four years ago as a presidential candidate but ultimately included in the law as a way to bring the insurance industry on board.

鈥淲ell, it should be pretty clear by now that I didn鈥檛 do this because it was good politics,鈥� he said. 鈥淚 did it because I believed it was good for the country.鈥�

Now, with the blessing of the Supreme Court, he gets to test the theory of his plan, which goes into full implementation in January 2014.

The court鈥檚 decision raises the stakes for the November election. If Obama is reelected, the Affordable Care Act is virtually certain to remain in law. If he loses, the law could be in peril. But Obama and his allies have been counting on growing public appreciation for the law as time goes on, and as its provisions go into effect.

The November election is likely to be decided on the state of the economy, not 鈥淥bamacare.鈥� But if the Republicans can succeed in convincing swing voters that Obama and the Democrats have overreached on health care 鈥� especially in the very personal decisions it entails 鈥� they will have created another avenue for defeating the president.