If Supreme Court scraps health-care law, who wins politically?

After a rare three days of argument at the Supreme Court, President Obama’s health-care reform sits in limbo – and will stay there until June, when the court is expected to rule on its constitutionality.

Until then, at least, the Affordable Care Act remains the law of the land. But the tenor of the questioning at the high court has led many analysts to suggest that the law could be struck down in whole or in part.

The political stakes are clear, and the Obama White House and reelection campaign are already calibrating their talking points. At a breakfast Thursday with reporters, the Obama campaign’s pollster, Joel Benenson, declined to speculate on whether a defeat in the Supreme Court would hurt or help Mr. Obama – or both. Instead, he sought to portray the president’s effort to reform the American health-care system as rooted in principle.

“The president said at the outset of his term he wasn’t doing health care for anything to do with politics, he was doing it because he believed it was the right thing we needed to do in this country,” said Mr. Benenson, speaking at Third Way, a centrist Democratic think tank.

Benenson cited the high cost of health care to families and businesses, “discriminatory” premiums for women who pay more than men, and insurance company practices that left sick people without coverage.  

Still, with the Supreme Court ruling expected in the heat of the presidential campaign, politics are unavoidable. If some or all of the law is struck down, it will be an embarrassing repudiation of the signature achievement of Obama’s presidency. Democrats could be demoralized, Republicans energized.

Some Democrats suggest that a loss could benefit the president by energizing an angry base.

James Carville, adviser to former President Bill Clinton, says a ruling against the law puts the Republicans in an awkward position – which benefits the Democrats.

“Just as a professional Democrat, there’s nothing better to me than overturning this thing 5 to 4, and then the Republican Party will own the health-care system for the foreseeable future,” Mr. Carville said March 27 on CNN. “I really believe that. That is not spin.”

Indeed, if the Supreme Court does in “Obamacare,” as critics call it, then the GOP mantra of “repeal and replace” will be obsolete.

If the entire law is struck down, the heat will be on to present an alternative that includes the elements the public likes. If only the mandate is struck down, and the popular parts remain law, they will face the question of how to fund a reform that will have lost the premiums of people no longer required to purchase insurance. The insurance industry maintains it needs full participation to afford lifting lifetime caps on coverage and other restrictions.

Obama, too, would face those questions. But he may at least benefit from having succeeded in passing a reform, after presidents of both parties tried and failed for decades to enact anything close to universal coverage.

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