By DAVID ESPO, Associated Press
WASHINGTON (AP) — The Supreme Court's 5-4 decision upholding the nation's health care law marks an enormous political victory for President Barack Obama in the heat of a re-election campaign, and affirmation as well for the Democrats' decades-long drive to extend coverage to millions of Americans who now go without.
Yet if the sweeping changes mandated by the law will go forward, so, too, the political controversy. Presidential challenger Mitt Romney and Republicans seeking control of Congress will see to that, seizing on Chief Justice John Roberts' ruling that the law levies a new tax on anyone refusing to purchase coverage.
The decision was rich in irony as well as in history.
It was the second time in four days — a ruling Monday threw out much of an Arizona state law on immigration — that a Roberts'-led majority upheld the Obama administration's position on a noisy, contentious issue that has roiled the nation's politics for years.
On this case, at least, Roberts seemed to be ruling through gritted teeth when he upheld the requirement that all Americans purchase health care.
"We do not consider whether the (law) embodies sound policies," he wrote of the health care legislation that Republicans have vowed to erase. "That judgment is entrusted to the Nation's elected leaders."
That was a reference to Obama and the lawmakers of both parties in Congress, whose disagreement is so deep that nary a Republican voted for the legislation when it slogged to passage in 2010. The polling then — as now — makes the law out to be a political negative, and Obama acknowledged as much in understated remarks at the White House.
"It should be pretty clear by now that I didn't do this because it was good politics," he said. "I did it because I believed it was good for the country. I did it because I believed it was good for the American people."
Republicans were anything but low-key.
They already had made it clear they would seek to repeal any part of the law left standing by the court, and Roberts' ruling seemed to hand them another talking point for the campaign to come.
"Our mission is clear: If we want to get rid of Obamacare, we're going to have to replace President Obama," Romney said in remarks delivered to television cameras with the Capitol dome as a backdrop. He said, if left in place, the law would raise taxes, cut Medicare and add to federal deficits.
Obama noted archly that in the past, some Republicans, the party's presidential nominee among them, have supported a requirement to purchase coverage.
It was a reference to the Massachusetts state law that Romney signed as governor, and it wasn't the only such jab of the day.
In fashioning key elements of the law, Justice Ruth Bader Ginsberg wrote in a concurring opinion at the court, "Congress followed Massachusetts lead."
Whatever the day's rhetoric, for the first time since Obama signed the measure, he and his supporters have the law and the Supreme Court on their side, and a clearer path toward implementing the legislation. Republicans can no longer rely on the justices, a majority of them appointed by GOP presidents, to wipe out the president's signature domestic accomplishment.
Not surprisingly, Obama turned his attention to the consumer friendly elements of the law that already have taken place, including reduced costs for some seniors with high prescription drug costs and a requirement that insurance companies provide coverage to children with pre-existing conditions. "And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spends too much on things like administration costs and CEO bonuses ...," he added.
"There's more," he said. "If you're one of the 30 million Americans who don't yet have health insurance, starting in 2014 this law will offer you an array of quality affordable private health insurance plans to choose from."
According to a 2010 estimate by the Congressional Budget Office, nearly 4 million Americans will have to pay a penalty — Roberts upheld its constitutionality as a tax — for not purchasing available coverage. The estimated cost will be a little more than $1,000.
The goal of universal coverage has been a Democratic priority for generations.