Health Care Ruling To Fuel Presidential Campaigns

The Supreme Court surprised a lot of people Thursday when it upheld the heart of President Obama's health care overhaul law. That is the requirement that everyone either have insurance or pay a fine or a tax. The decision was a big victory for Obama but it also gave his GOP rival Mitt Romney some opportunities.

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The Supreme Court surprised almost everyone yesterday when it upheld the heart of President Obama's health care law: a requirement that everyone either have insurance or pay a fine or tax. It's a big victory for president. It also gives his challenger, Mitt Romney, some important opportunities.

Here's NPR's national political correspondent, Mara Liasson.

MARA LIASSON, BYLINE: The Supreme Court decision means that the health care law is no longer a legal issue. It's a political issue. And that's despite President Obama's pleas to the contrary yesterday.

(SOUNDBITE OF SPEECH)

PRESIDENT BARACK OBAMA: The highest court in the land has now spoken. We will continue to implement this law. And we'll work together to improve on it where we can. But what we won't do, what the country can't afford to do is refight the political battles of two years ago or go back to the way things were.

LIASSON: But refighting the political battles of two years ago is exactly what will happen now, because the ultimate fate of the Affordable Care Act is up to the voters.

Republican presidential candidate Mitt Romney said the choice is stark.

(SOUNDBITE OF SPEECH)

MITT ROMNEY: Our mission is clear: If we want to get rid of Obamacare, we're going to have to replace President Obama. My mission is to make sure we do exactly that, that we return to the American people the privilege they've always had to live their lives in the way they feel most appropriate.

LIASSON: On July 11th, the House of Representatives will vote again to repeal the law - a symbolic effort, since repeal has no chance of passing the Senate this year. But with the law upheld, the pressure has eased on Romney to spell out what he'd put in place of the law's popular elements, like preventing insurers from denying coverage to people with preexisting conditions or charging women more than men.

In the ruling, the conservative chief justice joined the court's four liberals for the first time. That threw a curve ball to the Romney campaign, which boasts on its website that, quote, "As president, Mitt will nominate judges in the mold of Chief Justice Roberts."

But Republican pollster Whit Ayres said even though the president got a legal victory yesterday, Romney gained some new political ammunition.

WHIT AYRES: There's very little down side to this ruling for Governor Romney. He now has, as a centerpiece of the fall campaign, an unpopular law that is the president's signature achievement. So he has a giant target to shoot at the entire fall, and it's very unlikely that President Obama is going to persuade a majority of Americans between now and the election that this health care reform was a good idea.

LIASSON: The law is still unpopular, and extremely unpopular with the Republican base. But it's possible that the Supreme Court's good housekeeping seal of approval - delivered by an unusual left-right coalition - could change the minds of some swing voters.

Even so, says Ayres, the court's finding that the law was constitutional because the individual mandate was really a tax complicates things for President Obama.

AYRES: With the Supreme Court saying the individual mandate is really a tax, the president now has to defend a significant tax increase on all Americans, including middle and low-income earners, which he pledged not to do.

LIASSON: Indeed, as the White House desperately tried to round up votes for the law in 2009, the president famously insisted the mandate was not a tax. Then, this year before the Supreme Court, the administration's lawyer argued that it was. Now the president is pointing out that under the court's definition, Governor Romney's health care law raised taxes in exactly the same way.

(SOUNDBITE OF SPEECH)

OBAMA: People who can afford to buy health insurance should take the responsibility to do so. In fact, this idea has enjoyed support from members of both parties, including the current Republican nominee for president.

LIASSON: The Supreme Court ruling allowed President Obama to avoid a huge defeat and gave him a new opportunity to explain the law to the public - something Democrats admit they did poorly in the past. And Mr. Obama can also hope that grateful Democrats will respond with more energy and enthusiasm than they've shown so far.

Andy Stern is the former head of the SEIU, the union whose troops provided much of the grassroots effort to pass the law. Stern thinks the Democratic base will understand that the court ruling does not guarantee the survival of the Affordable Care Act.

ANDY STERN: I think it just makes it very clear to them that the energy, you know, has to be about re-electing the president, because we are now going to re-litigate politically what was - been resolved judicially.

LIASSON: Both campaigns immediately began fundraising off the high court decision, with Romney's campaign claiming to raise millions in just a few hours. But it remains to be seen what impact, if any, the ruling will have on public opinion and how much more time the candidates are willing to spend on health care when voters say they are most concerned about the economy.

Mara Liasson, NPR News, Washington.

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