The most important U.S. Supreme Court decision during a president’s re-election campaign may not have fundamentally changed the dynamics of the 2012 race.
In the hours after the court upheld President Barack Obama’s health-care law, both he and his Republican challenger, Mitt Romney, retreated to previously stated positions: Romney vowed to repeal and replace the law, while Obama touted its attributes and warned of the consequences of repeal. They sought to frame the issue in the larger context of what’s at stake for voters and underscored the centrality of the economy in the presidential election.
Still, the court handed the president a victory, averting a rebuke of his defining legislative accomplishment and one that eluded his Republican and Democratic predecessors for the last 100 years.
Its significance wasn’t lost on Obama who, looking into a television camera, told the American people: “The highest court in the land has now spoken.”
The setting -- the East Room of the White House -- has served as a stage for statements at key moments in Obama’s presidency, including his announcement of the May 2011 killing of al Qaeda leader Osama bin Laden.
“He avoided disaster and in the end reminded people that this has not been a do-nothing presidency,” said Douglas Brinkley, a presidential historian at Rice University in Houston. “He ate up about 18 months of his honeymoon period on this and now his Affordable Care Act has become a day-glow accomplishment.”
Yet health care remains one of the most divisive issues for the electorate. Obama’s aides indicated he wouldn’t try to bask in the court’s ruling, and Republicans hoped to capitalize on the controversy surrounding the law.
“I think people recognize that if you want to replace ’Obamacare,’ you’ve got to replace President Obama,” Romney told donors over breakfast this morning in midtown Manhattan. “And the urgency of doing that is something which is galvanizing people across the country.”
The court’s rationale for upholding the centerpiece of the 2010 Patient Protection and Affordable Care Act -- a requirement that most Americans obtain health insurance or pay a penalty -- also provided Republicans new ammunition for attacking Obama’s pledge to protect the middle class from new taxes.
Chief Justice John Roberts, a Republican appointee who wrote the majority opinion in the 5-4 ruling, said Congress had the authority to impose the requirement under its power to levy taxes.
“Obamacare raises taxes on the American people by approximately $500 billion,” Romney said yesterday in Washington as he reacted to the decision. “Obamacare cuts Medicare -- cuts Medicare -- by approximately $500 billion. And even with those cuts, and tax increases, Obamacare adds trillions to our deficits and to our national debt and pushes those obligations on to coming generations.”
Administration officials, briefing reporters on the condition of anonymity after the ruling, said Obama and his surrogates would make the case that the measure is a tax cut because individuals will get tax credits to purchase health care.
While the health-care law has now been validated, it remains unpopular in polling, and Americans’ views haven’t shifted in the more than two years since it was passed. Advisers to Romney and Obama say that voters are more concerned about the economy, and that barometers such as the June jobs report coming next week are likely to carry more import for the November election.
“It’s time for us to move forward, to implement and where necessary improve on this law,” Obama said yesterday. “Now’s the time to keep our focus on the most urgent challenge of our time: putting people back to work, paying down our debt and building an economy where people can have confidence that if they work hard they can get ahead.”
For Obama’s campaign going forward, the law -- designed to expand coverage to at least 30 million people and representing the biggest change to the U.S. health system since Medicare and Medicaid were established in 1965 -- will likely remain one of the main accomplishments he lists in his appeal to voters, along with equal pay for women and Wall Street reforms.
“This is important, but in the end, I think they are still going to go and vote their pocketbooks,” said David Redlawsk, director of the Eagleton Center for Public Interest Polling at Rutgers University in New Jersey.
Roberts, whose confirmation Obama voted against as a U.S. senator, joined four Democratic-selected justices to give the the president a majority on a law that has divided the nation along ideological and partisan lines.
The decision is the culmination of an epic legal fight that featured the longest Supreme Court arguments in 44 years, a record number of briefs and extraordinary public interest in a high court case. The case tested both the constitutional powers of Congress and the willingness of the Roberts court to overrule the other two branches of the federal government.
Republican-appointed Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito dissented, saying they would have struck down the entire statute.
The court did modify the law’s extension of the Medicaid program for the poor by saying the federal government can’t threaten to withhold existing money from states that don’t fully comply.
Romney’s own history with the individual mandate, however, has complicated his argument against the law. As governor of Massachusetts, Romney pushed to enactment a health-care measure that also contained such a mandate. He has argued that while it was right for his state, it is inappropriately applied nationally.
Administration officials yesterday called Romney’s law “the mirror image” of Obama’s and sought to paint Romney as the original architect of the mandate-included national measure.
Like Obama, Romney will continue to address the health-care issue through the prism of the jobs and the economy -- a tack taken in the first TV ad by his campaign following the ruling. Romney will argue the law is a drag on the economy and a top concern of the business community, said Vin Weber, a former U.S. representative from Minnesota and a Romney adviser.
“I think this gives Obama bragging rights for a couple days, but I don’t think much longer than that,” Weber said. “That jobs report will tell us more about strategy going forward than the Supreme Court ruling, as important as it is and as focused on it as we are today.”
Still, the decision presented the Romney campaign with challenges.
His pledge to repeal a now-confirmed statute will intensify questions about how he would cover the tens of millions of uninsured people the law is designed to cover, including some who have pre-existing medical conditions that could cause insurers to deny them coverage if they were permitted to do so.
His campaign aides see no upside in providing such specifics, believing that would only give Obama and Democrats a political piñata to swing at, and are determined not to do so.
Instead, they are using the court decision to stoke public discontent with the health-care measure. Romney’s campaign put the word out less than an hour after the announcement that it had raised $100,000 in unsolicited donations. By this morning, the total had jumped to $4.2 million, campaign spokeswoman Andrea Saul said in a Twitter message.
Obama’s campaign, playing off the Romney fundraising effort, attacked him over the lack of specifics he’s offered on health policy.
“It’s perverse that Mitt Romney won’t share details about what he’d do for the millions he’d leave uninsured or at the whims of insurance companies when he ‘kills Obamacare dead,’ but he’ll share the hourly details of his fundraising after the Supreme Court ruling,” Ben LaBolt, press secretary for the president’s re-election team, said in an e-mail today.
LaBolt also said, “We’ve outraised the Romney campaign in that time period” after the decision, without providing details.
A challenge for Obama is that “the intensity of opposition to the law has always been stronger than the intensity of support,” said Mollyann Brodie, director of the Kaiser Family Foundation’s public opinion and media research.
Since its passage in March 2010, public opinion has skewed consistently against the entire bill. Only 42 percent of Americans had a favorable opinion of it, according to an April poll from the Kaiser foundation, which tracks views of the health-care law -- largely unchanged from the month after it was signed in March 2010, when 46 percent favored the law.
Obama and other Democrats never effectively explained to the American public how one of the most popular elements of the law -- forcing insurers to cover people with pre-existing health conditions -- is tied to the most unpopular provision: the mandate that forces Americans to carry insurance or pay a penalty.
Sixty percent of Americans favor the provision prohibiting insurance companies from denying coverage because of a person’s medical history -- yet 70 percent have an unfavorable opinion of the mandate, according to the Kaiser poll.
“It’s a win on the leadership side, voters admire people who get things done,” said Robert Blendon, a professor of health policy and political analysis at Harvard University in Cambridge, Massachusetts. “But you’re not going to shift a lot of health policy voters. People who don’t like it will still not like it, people who like it will still stay there.”