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An epic victory for Obama, but one that could backfire on polling day

Broader political dispute over 'Obamacare' has long ceased to be about health care per se, but about the reach of government and the power of Congress to legislate and control people's lives

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Barack Obama is not a man given to public displays of emotion but one imagines there were a few "high fives" in the Oval Office shortly after 10am yesterday (Thursday) when news came through that the US Supreme Court had upheld his signature health reforms.

This was a momentous decision that confounded the pundits' predictions, delighted the White House, but much more importantly, defined at a stroke the key ideological battle lines for November's general election.

It is hard to overstate how much was at stake for Mr Obama. As his Republican challenger Mitt Romney put it before the result came out, if the Supreme Court had struck down the Affordable Care Act, then Mr Obama's first three-and-a-half years in office would have appeared "wasted".

Obama's elation at the Supreme Court judgment, however, will be tempered by the knowledge that the court's reasoning that the ACA was constitutional because it amounted to a "tax", puts a nasty political sting in the tail of this judgment.

Republicans, ever eager to seize on Obama's instincts, as they see it, to expand government, raise taxes and pile on the debt, will pounce on that notion. "ObamaCare" care is a tax, the campaign leaflets will say, and the Supreme Court agrees with us.

They will also remember that Obama, after he came to office pledging to reform America's out-of-control health care sector, explicitly denied that his legislation amounted to a tax.

In truth, the broader political dispute over the Affordable Care Act has long ceased to be about health care per se, but about the reach of government and the power of Congress to legislate and control people's lives. The so-called "mandate" requiring every single American, by law, to buy health insurance is anathema to many Americans - and not just Republicans - with recent polling showing that only 30 per cent support the clause compelling everyone to buy health insurance by 2014 or face a fine.

However, the decision to uphold the ACA, while motivating an already angry Republican base (the Romney camp says they raised $100,000 within minutes of the verdict) is not a piece of unalloyed political gold for Mr Romney.

Republicans are aware that while the public instinctively disapproves of being ordered to do anything, polls also show that, to the tune of 60% or more, the public approves of the Act's attempts to curb the loathed insurance companies - ending gender screening; allowing children to stay in parents' policies; and ending the use of pre-existing conditions to deny cover.

Romney will need to finesse this public opinion paradox, beating the Republican war drums against big government while hoping that the ideological noise drowns out the Democrat's "good news" of the tangible benefits that ACA delivers to ordinary families in tough times.

Unfortunately for Republicans, they have chosen a candidate in Romney who has an Achilles' heel when it comes to attacking Obama for his reforms, which is that they were based on Romney's own 2006 "Romneycare" health reforms in Massachusetts that were built on a mandate. Don't expect Obama to allow the voters to forget it - indeed in his national address in response to the ruling yesterday he pointed this very fact out.

These wrinkles explain why this week, in briefings ahead of a decision they expected to win, Congressional republicans were warned by their own leadership not to "spike the ball" - a reference to the jubilant celebrations of the scorer in American football.

As it turns out, they lost the game; but handled correctly, they must hope that the defeat provides a rallying call that helps them galvanise supporters for an even bigger victory come November.

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