The Supreme Court settled one matter when it upheld the Patient Protection and Affordable Care Act: President Barack Obama's landmark health reform law is constitutional and will go into effect as originally planned. But a wide range of unintended consequences could ripple outward from the court's historic decision.
[Photos: Supreme Court Upholds Healthcare Law]
Here are a few:
Mitt Romney gains a tailwind in the election race. Conservatives clearly plan to keep fighting the law, with efforts now shifting toward new legislation to repeal Obamacare, which Romney has identified as one of his "Day One" priorities. Since the ruling is a setback for Republicans, it could motivate the conservative base, enhance Republican fundraising, and bring Romney a few additional votes in November. Democrats, meanwhile, could grow complacent if they feel the law is now on safe ground. Since a small number of votes in a few swing states could determine who wins in November, any shift in electoral momentum is key.
Economic issues take a back seat. Business leaders are growing more worried by the day about the "fiscal cliff" coming at the end of the year and incoherent policymaking in Washington. Some economists are uncertain about momentous tax cuts and spending hikes scheduled to go into effect at the end of the year. If a renewed fight over repealing Obamacare edges out economic issues in Washington, businesses will rein in spending and a weak economy could tip into recession.
Consumers end up even more confused. By characterizing the law's individual mandate as a tax, the Supreme Court introduced a new concept that's likely to make the overall law, which is already enormously complex, even more perplexing.
"The court endorsed a bait-and-switch in which Congress can pass a tax, but not call it a tax," says Karen Harned of the National Federation of Independent Business, a lead plaintiff in the suit opposing the law. That's likely to become a rallying cry of opponents pushing for repeal, and it could make consumers even more leery of a law that's already poorly understood. Complexity adds to public skepticism, which could impede compliance with the law and its overall effectiveness.
Americans trust government even less. People are already disgusted with government, and ongoing rancor over Obamacare could easily undermine faith in elected officials even more. Recent polls by Gallup show record-low levels of trust in Congress, the presidency and even the Supreme Court. Since Obamacare was already unpopular, with nearly half of all Americans opposed to it, its full implementation could generate further unrest among voters. That matters because Washington must accomplish some important and difficult things in order to get the U.S. economy back on sound footing, such as reforming the tax code and dealing with entitlements like Medicare and Social Security. Growing cynicism among voters will make that even harder.
Rick Newman is the author of Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.