After months of deliberation, the Supreme Court ruled to uphold the Affordable Care Act in a historic 5-4 decision. Make no mistake: the electoral consequences of the Court’s decision pale in comparison to the implications for the health care system and the scope of federal authority. On those far more important questions, I’ll be reading Jonathan Cohn and Jeffrey Rosen for superb insights and analysis, and you should be too.
While many of the policy and legal consequences of the decision will probably be found in the text of Roberts' opinion, the political fallout is uncertain. There is no question that the ruling represents a “win” for the President—his central legislative accomplishment survives and so does its cornerstone, the individual mandate. But beyond the basic “win” or “loss” formulation for the administration’s agenda, today’s decision is unlikely to translate into substantial electoral gains for either side.
If the Court had gone a different direction, the electoral consequences could have been more significant. But since the ruling preserves the status quo, the fundamentals of the health care debate remain essentially unaltered. Dissatisfaction with the health care law is already priced into the President’s approval ratings—Obama’s pursuit of health care reform was a defining element of his first term, and voters have already judged him on that basis. Opposition to the health care law was never driven by arcane constitutional concerns, even if many viewed it as government overreach. Indeed, constitutional concerns were not given much credence in mainstream media discussions until long after the passage of the ACA.
Today’s decision will not dissuade Romney from vigorously campaigning against job-killing ObamaCare, but the President’s response could alter the trajectory of the political debate. Polls consistently show that the public disapproves of the ACA, suggesting that the Obama campaign would be wise to move the discussion away from health care as soon as possible. But while the intensity of the law’s detractors justifiably receives attention commensurate with their outrage, many Americans harbor mixed feelings. Why are so many unsure about such a controversial and well-known bill? Many simply do not understand the ACA, which is not surprising given the rancorous political debate and the complexity of the legislation. According to surveys by the Kaiser Family Foundation, between 42 and 55 percent of voters say they are “confused” by the health care law, and 39 percent say they do not know enough about the law to assess how it will affect them personally.
With belated validation from the Supreme Court, Obama could be tempted to resell the bill. Will Obama attempt to capitalize on the law’s newfound legitimacy, to the extent that the Supreme Court offers any? Prior to the Supreme Court’s hearings, the Obama campaign seemed to embrace the ObamaCare label, perhaps indicating their intention to promote the bill once legal issues were resolved. While it might seem unstrategic for Obama to return attention to an unpopular proposal, a resell could produce better results than the initial attempt, if for no other reason than the absence of an on-going partisan debate in Congress. Perhaps more importantly, Obama is better positioned to promote the law against Mitt Romney, who enacted a similar health reform scheme in Massachusetts. Romney’s previous measures will complicate his ability to credibly challenge the ACA and particularly the individual mandate. In that respect, Santorum was surely correct.
Reselling the health care law would not be easy. Although polls suggest that many of the ACA’s components are quite popular, voters do not view the ACA as an assembly of popular components tainted by the mandate—and analysts who assume they do based on polling have been misled by the organization of a questionnaire. Opinions of the health care law are probably quite entrenched at this stage, and only a concerted and sustained effort could succeed in moving a skeptical public. But such an effort would detract from Obama’s ability to focus on the economy or Romney’s record, or could be vulnerable to the criticism that Obama is not focused on creating jobs. The law is certainly unpopular enough that Obama would be taking a big risk by devoting any more attention to the law than necessary.
Even in the best case scenarios for either candidate, today’s ruling is unlikely to fundamentally reshape the race. The most consequential moments of the last two years have not realigned perceptions of the President’s performance. Obama’s approval rating has tracked on either side of 47 percent for two years with just three exceptions: the Giffords assassination attempt, the Bin Laden assassination, and the debt ceiling debacle. In each case, perturbations to long lasting trends were temporary and Obama’s standing returned to its moors. The health care ruling may be significant enough to add a four perturbation to the long term trend, but the presumption should be that it will prove temporary, like those that came before it.
The Osama Bin Laden assassination is particularly instructive. At the time, many wondered whether the strike ensured the President’s reelection, but, thirteen months later, the historic operation has subsided into the background. If the Bin Laden raid did not fundamentally alter perceptions of the President, why would the health care ruling? Unlike today’s decision, the Bin Laden assassination truly represented a possible game changer: it introduced new and plausibly decisive information about the President’s performance that the public had not yet incorporated into their calculus. No matter how groundbreaking today’s decision may be, it does not represent such a decisive event. Obama already passed the ACA and the public has judged him on that basis. Unless today’s ruling prompts a pronounced shift in Obama’s efforts to sell the law, expect the fundamentals of the race and health care politics to continue unaltered.