The most unexpected thing about today's ruling in the US Supreme Court about Obama care wasn't so much that it was approved with a narrow 5-4 margin, but that the swing vote was John Roberts and not Anthony Kennedy. Usually it is Kennedy that is the swing vote, while Roberts is considered to be part of the conservative bloc, together with Clarence Thomas, Antonio Scalia and Samuel Alito. But now it would seem then that the Supreme Court has four reliable liberals, three reliable conservatives and two swing voters.
As for the ruling, two things should be noted. First of all, it is clear that the mandate to buy health insurance means a reduction in the freedom of Americans. Secondly, it is however also clear that it is no more so than existing welfare state programs like Medicare and Social Security, where people are in effect through the tax system forced to buy health insurance and pension insurance for when they become older than 65. So if Obamacare is unconstitutional, then there wouldn't have been any reason not to consider Medicare and Social Security as unconstitutional, something that few leading Republicans would openly argue for.
As for the political impact, Mitt Romney is the big loser. Some argue that he is a winner because the health care insurance mandate is unpopular, but I disagree considering that he as recently as 2007 called it "ultimate conservatism" and has yet to renounce his old statements he simply has no credibility arguing against Obamacare.