President Obama probably never assumed that when he signed the Patient Protection and Affordable Care Act into law on March 23, 2010, he was kicking off one of the most historical and political legal battles in modern history. Obama and his liberal colleagues in the House and Senate that passed the 2,700-page behemoth were either horribly naïve, or quite insouciant as to the consequences that would soon follow.
That same day, Virginia and 13 other states filed suit, challenging the constitutionality of Obamacare. Over the next two years the number grew to a grand total of 27 states. The entire nation watched this past March as oral arguments were made in front of the Supreme Court.
It wasn’t an easy three days for U.S. Solicitor General Donald Verrilli, who at one point even faced laughter while debating with the justices as to whether or not the penalty for not buying insurance constituted a tax. After deliberations ended, every two-bit talking head started speculating as to how the court would eventually rule.
There are several different ways that the court could rule when it comes to the constitutionality of Obamacare. No matter which way it rules, at lot of people will be angry.
Outcome 1: The Law is Upheld
If the Supreme Court upholds the entire law, it'll be bragging time for Obama. He’ll be able to claim that he alone has successfully done what presidents have been talking about for over 50 years. However, the honeymoon wouldn’t last long.
While Obama’s staunchest supporters would be gloating, many others would be furious. In the middle of an already brutal election year, having to defend such an unpopular law could prove to be very difficult for Obama. The Republicans, and presumptive GOP nominee Mitt Romney would have a freshly polished target to attack all the way to November.
Despite having passed a health care law in Massachusetts, former Governor Romney has repeatedly stated that each state should get to do what it wants, and will be more than happy to use it against the president.
Other lawsuits at lower courts would no doubt proceed, each trying their best to dismantle other parts of the law. Republicans in Congress would also continue to pass other bills meant to gut the bill from the inside out.
Outcome 2: The Mandate is Struck Down
Without the individual mandate, the Congressional Budget Office predicts that nearly half of 32 million people that receive coverage because of the law will not be covered. There’d be a rush to save the medical industry through legislation, as doctors and medical institutions would be slammed with a double whammy of new taxes and lower Medicare reimbursements, but without the extra patients to help them pay the bill. Without immediate action, many doctors could suddenly find retirement a more feasible option than dealing with the increased cost of doing business.
Of course, there was never a guarantee that they would be making more money due to the increased number of patients, but that’s another discussion altogether.
President Obama could claim both victory and defeat. While the main crux of the law would be broken, many other parts of it, including covering people with pre-existing conditions, would still be intact. He would vow to keep fighting, although given his recent track record, no one would be surprised if Obama just issued executive orders to try and fill the void. He’d also continue to publically flog the GOP.
Republicans on the other hand would vow to completely repeal the rest of the bill if they emerge victorious in November.
Outcome 3: The Entire Law is Struck Down
It’ll be an intense blow to Obama and his entire administration if the entire law is declared unconstitutional and thrown out. The mandate, along with all taxes, market changes and expanded insurance coverage could be thrown out the window.
Republicans and Democrats would both immediately begin offering new replacements to fill the void, however it is very unlike that anything would become a serious possibility until after the November elections. While Democrats would try their best to paint Republicans as oppressive and heartless, Republicans would make an increased push for their "repeal and replace" initiative.
Obama could be seen to have wasted the better part of his first term, especially since so much time, effort and favors were spent to get the bill passed. The president’s credibility would suffer a crippling blow, much like President Jimmy Carter’s did after the failed Operation Eagle Claw when he tried to save American hostages in Iran.
Obama would try to move on by beating up the Supreme Court, in particular the Bush appointees to the Court. The devastating hit could be difficult to overcome. Romney could also breathe a sigh of relief, as health care, considered by many to be his one Achilles Heel, would be off the table.
No matter what happens, the storm that ensues will be incredible. Since its first landmark case, the Supreme Court has had to learn that it cannot please everyone. If the law is upheld, it could still face a complete repeal should Romney win the presidency. If only the mandate is declared unconstitutional, every legislator on Capitol Hill will try to be the one to come up with the next grandiose idea.
If the entire law’s thrown out, it’s a distinct possibility that many states will begin to craft their own reforms, rather than continuing to wait for the federal government to get its act together.